ORDER / RECEIPT FORM
(Our Lady of Loving Compassion poster 18"X24")

Order date: ________________________________ Order #: (will be filled in when your order is sent) ________________

Name/Company: _________________________________ Contact Person: ____________________________________

Address: ___________________________________ City: ________________ State: __________Zip: _____________

Tel: _______________________ Fax: ______________________ E-mail: ____________________________________

Poster of
Our Lady of
Loving Compassion


Please fill in your order below

Quantity x $ cost

total

Grana Fine acid-free paper

______ x $10.00

$___________

Liscio Limited-autographed

______ x $15.00

$___________

Grana Grossa
Limited-autographed

______ x $18.00

$___________

 

              
              Total amount =


$_________


Total amount: $___________

+Tax: $___________
New York residents add your tax to the above Subtotal. Tax Exempt organizations, please include certificate with order.
+Shipping & Handling:$___8.00____

Grand total:$___________

Please send the complete Order Form with check payable to New Helfta Atelier . P.O. Box 464 . Geneseo, NY 14454.
An order will be shipped out as soon as the complete Order Form and payment are received.
Shipping will take approximately from 3 to 5 business days. Thank you for your business

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