Print Order Form Fax to 02 9981 1424 Deborah Broughton Original Art
1. Unframed Prints
1a: Small Prints (available in sets of three or five only)
Print Number / Name
/Matt Colour
1 / Black/White2 / Black/White
3 / Black/White
4 / Black/White
5 / Black/White
/
Print Number / Name
/Matt Colour
1 / Black/White2 / Black/White
3 / Black/White
4 / Black/White
5 / Black/White
Total Cost:______($30 for 3, $45 for 5 – excl. p&h)
1b: Medium Prints
Print Number / Name
/Matt Colour
1 / Black/White2 / Black/White
3 / Black/White
4 / Black/White
5 / Black/White
/
Print Number / Name
/Matt Colour
1 / Black/White2 / Black/White
3 / Black/White
4 / Black/White
5 / Black/White
Total Cost:______($25 each - excl p&h)
1c: Large Prints
Print Number / Name
/Matt Colour
1 / Black/White2 / Black/White
3 / Black/White
4 / Black/White
5 / Black/White
/
Print Number / Name
/Matt Colour
1 / Black/White2 / Black/White
3 / Black/White
4 / Black/White
5 / Black/White
Total Cost:______($35 each - excl p&h)
1d: 4 Series Prints (please stipulate the images you would like)
Print Number / Name
a /Matt Colour
Black/White
b
c
d
/
Print Number / Name
a /Matt Colour
Black/White
b
c
d
Total Cost:______($45 each - excl p&h)
ADD Post/Handling (Aus) $8 plus $1 for each additional order combined:$______
Post/Handling (Overseas) $15 plus $2 for each additional order combined: $______
GRAND TOTAL: $______
2. Framed Prints (Ship to Australia Only)
2a: Small Framed Prints
Print Number / Name
/Matt Colour
/Frame
1 / Black / White / Timber/Silver2 / Black / White / Timber/Silver
3 / Black / White / Timber/Silver
4 / Black / White / Timber/Silver
Cost:______($30 each excl p&h - $9 for first print, $3 each additional combined)
2b: Medium Framed Prints
Print Number / Name
/Matt Colour
/Frame
1 / Black / White / Timber/Silver2 / Black / White / Timber/Silver
3 / Black / White / Timber/Silver
4 / Black / White / Timber/Silver
Cost:______($45 each excl p&h - $12 for first print, $3 each additional combined)
2c: Large Framed Prints
Print Number / Name
/Matt Colour
/Frame
1 / Black / White / Timber/Silver2 / Black / White / Timber/Silver
3 / Black / White / Timber/Silver
4 / Black / White / Timber/Silver
Cost:______($60 each excl p&h - $15 for first print, $3 each additional combined)
2d: 4 Series Framed Prints (please stipulate the images you would like)
Print Number / Name
/ Circle preferred:Orientation:
Vertical/Horiz
Matt Colour
Black/White
Frame
Timber/Silver
ab
c
d
/
Print Number / Name
/ Circle preferred:Orientation
Vertical/Horiz
Matt Colour
Black/White
Frame
Timber/Silver
ab
c
d
Cost:______($90 each excl p&h - $17 for first print, $3 each additional combined)
Shipment Total: $______
GRAND TOTAL: $______
3. Your Details
Name:______
Delivery Address:______
______
State:______Zip/Postcode:______Country:______
Email:______
Contact Number:______
Payment options:
1. I have enclosed a cheque/money order made out to Deborah Broughton Original Art in the amount of ______including postage (if required)
2. Please send me bank details so I can direct debit the total of $______
3. Please invoice me the total of $______via PayPal
4. Please bill the amount of $______including postage to my credit card (Visa, Bank Card or MasterCard only)
Visa MasterCard Bank Card
Card Number:
Name (As appears on card):
Expiry Date: /
Signature : Date:
PLEASE RETURN COMPLETED FORM BY FAX: 02-9981 1424
- Forms can also be posted to PO Box 349, Dee Why, NSW, 2099.
- Orders not containing Credit Card information can be emailed to
Please allow 1-2 weeks for delivery to Australia, 2-3 weeks for Overseas orders.
To Fax from outside Australia please dial +61 2 9981 1424
Deborah Broughton Original Art
Ph: 0415 457 704 Email: Web:
PO Box: 349 Dee Why NSW 2099