Graphics Order Form

Please PRINT OUT, COMPLETE and MAIL to the following address:

I. Nethercott
Box 97
Vienna, Ontario CANADA
N0J 1Z0

We accept cheques or money orders, made payable to I. Nethercott. Allow 2-3 weeks for processing and mailing.

SECTION 1
Graphics Set 'Blank' 'Customized' * 'Customized Plus' *
01 Purple__$2CN ($1.50US) **__$5CN ($4US) **__$8CN ($6.50US) **
02 Wood__$2CN ($1.50US) **__$5CN ($4US) **__$8CN ($6.50US) **
03 Brick__$2CN ($1.50US) **__$5CN ($4US) **__$8CN ($6.50US) **

AlphabetsAll Sets__$5CN ($4US) **
Individual Set Name:_________________$1.20CN ($1US) **
Individual Set Name:_________________$1.20CN ($1US) **

Full Package
All above sets, in blank,
as well as all alphabets		No Customization__$8CN ($6.50US) **

Photo FramePlease provide scanned
photo on disk		$1CN ($1US) EACH______________ **

ADDITIONAL
CUSTOMIZATION
($1.00 Each)

________________

SUBTOTAL________________
S&H $1.50CN,
$1US (if applicable)
________________

TOTAL________________

*Complete Section 3 below for customization
**Plus shipping & handling if applicable. See note below in Section 2.

SECTION 2
Option 1:
TO RECEIVE YOUR GRAPHICS ON DISK VIA REGULAR MAIL, PLEASE COMPLETE THIS SECTION AND ADD $1.50 CAN ($1.00 U.S.) SHIPPING & HANDLING TO YOUR TOTAL ORDER.
Your Name:________________________________________________________
Street Address:________________________________________________________
City:________________________________________________________
Postal/Zip Code:_______________________ Country: __________________________
Option 2:
TO RECEIVE YOUR GRAPHICS VIA EMAIL, PLEASE COMPLETE THIS SECTION. SHIPPING & HANDLING DOES NOT APPLY.
Email Address:___________________________________________________

SECTION 3
GRAPHIC NAME TEXT TO BE PLACED ON GRAPHIC - PLEASE PRINT
BAN1 (Small)___________________________________________________________
BAN2 (Large)___________________________________________________________
BUT1 (Medium)___________________________________________________________
BUT2 (Medium)___________________________________________________________
The package price includes customization of one of each of the designated graphics. Additional customizations available at a charge of $1.00 (CAN and U.S.) each. Please attach a separate page indicating the graphic name and desired text.

Free Book & How-To Literature | HTML Done Well | Pixel x Pixel Graphic Design
Home