limited edition print order form, Russ Fisher, artist, water color painter, Williamsburg, Charlottesville, Massanutten, Virginia country landscape, line drawing, Fischer


Russell Fisher Order Form

Ordered For

Name: ______________________
   (First)                     (Last)
Phone: ______________________
(Area Code)    (Phone Number)
Address:
______________________
 (Number)                 (Street)
______________________
  (City)     (State)     (Zip Code)
Picture Title:__________________ ....................
Original Ordered:____      Print Ordered:_____
Quanity ordered: _______
Price : $________
Tax 5.00 % Virginia Residents: $________
Shipping & handling of one print: $15.00 $________
Shipping & handling of original: please call for cost $________
Total:
$________

___________________________
Visa or Master Charge#

______/______
Expiration Date month/year

______________________________
Full Name on Credit Card

___________________
Security Number on Back of Credit Card

________________________________________________________
Mailing Address Associated with Credit Card- Street #, Street Name, City, Zip Code

________________________________________________________
Signature

Print, then mail this form with your check or money or credit card order to:

 RUSSELL W. FISHER
104 Woodpecker Way
Afton, VA 22920

(540) 456-6987

  home

russellwfisher@aol.com

  email


Please allow 2-4 weeks for delivery

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