Mail in Order Form GO BACK

 Fine Arts Emporium
431 Arch Dr - Rock Hill, South Carolina, 29730

O R D E R - F O R M

SHIP TO BILL TO (USE ONLY IF DIFFERENT)
NAME   NAME  
ADDRESS 1   ADDRESS  
       
CITY/STATE/ZIP   CITY/STATE/ZIP  

PAYMENT BY

MONEY ORDER   AMOUNT ENCLOSED $
CREDIT CARD   CARD TYPE VISA / MasterCard
CARD NUMBER    
EXPIRATION DATE   DATE ORDERED ____/_____/_____
ITEM NO. PAINTING TITLE/ STUDIO NAME TOTAL AMOUNT
 

 

 

 

 

     
SUBTOTAL
 
SHIPPING AND HANDLING  
SC RESIDENTS ONLY ADD 5% TAX  
TOTAL DUE  

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SIGNATURE