Orion Works Purchase Order Form
For Original Paintings
(Print this form. Mail or FAX your order)

MAILING ADDRESS:
Orion Works
, 2701 Eugenia Avenue, Box 343, Madison WI 53705

PHONE (voice): (608) 231-2040
FAX: (608) 231-2524

TITLEPRICE






TOTAL:
Canadian Orders add 25% Surcharge:
SUBTOTAL:
SHIPPING & HANDLING (see details):
GRAND TOTAL:


Method of Payment:

[_] Check Enclosed, Make checks payable in USA Dollars to: Orion Works
or Steven Vincent Johnson
[_] Credit Card:
[_] VISA [_] Master Card
Credit Card No:

Expiration Date:

Signature:



Shipping Address:

Name:

Address:


City:

State:
Zip:
Country:

FAX:
Phone:

Email Address:

Shipping and Handling: Costs will vary depending upon the final size and weight of the package, where it is going, how fast you want it there, and insurance. See Packing and Shipping Guidelines for additional details.

Payment Terms: A payment contract plan can be arranged with the artist. Upon completion of final payment, including shipping and handling costs, painting will be delivered.