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| *Name | Enter First and Last Name | |
| *Street Address | ||
| Address (cont.) | ||
| *City | ||
| *State | ||
| *Zip/Postal Code | ||
| Country | United States | |
| *Home Phone | Enter as xxx-xxx-xxxx | |
| *Work Phone | Enter as xxx-xxx-xxxx | |
| FAX | Enter as xxx-xxx-xxxx | |
Please provide the following ordering information:
| QTY | ITEM | DESCRIPTION | PRICE |
You only need to fill this out if different from above address.
| SHIPPING | ||
| Street Address | ||
| Address (cont.) | ||
| City | ||
| State | ||
| Zip/Postal Code | ||
| Country | United States | |
| NOTE: This form is sent | ||
| BILLING | via email, not over a | |
| *Payment Method | secure line. You can call | |
| Cardholder Name | me at: 706-754-0804 | |
| Card Number | to place your credit card | |
| Expiration Date | order if you prefer. |
Shipment will be made within 7-10 days following clearance of credit card or check. Satisfaction is guaranteed if returned, at the customer's expense, within 10 days of receipt after confirmation by fax or email of approval of return. In placing an order, the customer understands and agrees that the copyrights to the images remain with the artist.
NOTE: I will not be able to accept any International Orders.
You will be sent a price confirmation email with the total price including shipping and handling (and 7 % sales tax if a Georgia resident).


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Copyright 2001, Boozer Enterprises.
All Rights Reserved.