Order Form

 

Last name _________________________  First name _________________________

Address     ____________________________________________________________

City             _________________________   State _______  Zip ___________________

Country     _________________________

Phone       _________________________   Email ______________________________

 

Quantity Print Number Size Price each Total
         
         
         
         
         


  Size          Price            Actual Print Size
  8 x 10        $55               (6.66 x 10)
11 x 14        $90               (9.33 x 14)
16 x 20        $150             (13.33 x 20)

Sub-total   
Sales tax (Pa residents only - add 6%)   
Shipping and handling (add 10%)   
Total   



Complete the information and mail it with a check or money order to:

Alpenglo, Inc.
PO Box 16
Imperial, PA  15126-0016

Allow 4 to 6 weeks for delivery.