ORDER FORM
Bizzart Images
FAX: (514) 457-9243
E-MAIL: steve.w@videotron.ca

Note: Sending this will reserve your Limited Edition
Print for up to two (2) weeks until your check or money
order arrives by mail. Please see this URL for more information.
Bizzart Illustration: http://pages.infinit.net/stevew/bizzart/

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|-------------------------------|----------|------|
|                               | QUANTITY | COST |
|-------------------------------|----------|------|
|           ARTIST SIGNED PRINT |          |      |
|-------------------------------|----------|------|
|       PACKAGE CO-SIGNED PRINT |          |      |
|------------------------------------------|------|
|                                SUB TOTAL |      |
|------------------------------------------|------|
|                       POSTAGE & HANDLING |      |
|------------------------------------------|------|
|           CANADIAN RESIDENTS ONLY GST 7% |      |
|------------------------------------------|------|
|           QUEBEC RESIDENTS ONLY PST 6.5% |      |
|------------------------------------------|------|
|                                    TOTAL |      |
|------------------------------------------|------|


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FAX TO: (514) 457-9243

E-MAIL TO: steve.w@videotron.ca

MAIL TO: 22 Sunny Acres
         Baie D'Urfé
         Quebec, Canada
         H9X 3B6