Order Form for Debbora's Gallery

PRINT OUT THIS FORM & MAIL TOGETHER WITH CHECK OR MONEY ORDER MADE OUT TO:

Integrity Tech Enterprises
9630 Nichols Lake Rd.
Milton, Florida 32583

Please allow 2 to 4 weeks for your order to arrive.

BUYER INFORMATION:

NAME:
ADDRESS:
CITY:
STATE:
ZIP CODE:
DAY PHONE:
EVENING PHONE:
E-MAIL ADDRESS:

SHIP TO ADDRESS ( If different from above ):

NAME:
ADDRESS:
CITY:
STATE:
ZIP CODE:
PHONE:

ORDER INFORMATION:

QUANITY ORDER NO. ITEM DISCRIPTION SIZE ART NO. PRICE EACH + TOTAL PRICE

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SUBTOTAL _____________________

( READ BELOW) + SHIPPING _____________________

FLORIDA RES. +7% TAX _____________________

(READ BELOW) INSURANCE? +_____________________

GRAND TOTAL ENCLOSED______________________

SHIPPING & HANDLING IS $5.00 FOR THE FIRST ITEM & $1.00 PER ITEM THERE AFTER.

INSURANCE IS $2.00 PER HUNDRED OPTIONAL HIGHLY RECOMMENED IF YOU HAVE ORDER LIMITED ADDITION PRINTS. To send a checks by E-Mail or FAX

Return to: Debbora's Gallery .... Return to: Awesome Artist Avenue ..... Return to: Integrity Tech City