Limited Edition Print Order Form - Virginia Lloyd-Davies
July 22. 1999


Code
Qty
Title
Mat Color*
framed
unframed
total
PWB
 . purple wisteria &birds . . . $
PBIB
 . purple iris with bud . . . $
PMGBY
 . purple morning glory . . . $
RO
 . red orchid . . . $
RRBY
 . red rose w/b'fly . . . $
RTB
 . red tulip w/bee . . . $
PBI
 . purple iris . . . $
PW
 . purple wisteria . . . $
BI
 . blue irises . . . $
BLB
 . blue lupine & butterfly . . . $
BB
 . blue bluejay . . . $
BIB
 . blue irises & butterfly . . . $
sub-total
 $
VA res. add 4.5% sales tax
 $
shipping
 $
Total
 $

Include your name and address in the space above.

* Mat colors - ivy, magenta or cream

Prices:    $38.00 each - matted & shrink-wrapped
             $65.00 each - matted & framed (gold metal only)

Shipping:    unframed - $8.00 for first :  $5.00 for each additional
                 framed - $10.00 for first :  $8.00 for each additional

Circle one     Visa      MC

Credit Card #                                                                   .

Expiration Date  (00/00)           /         .

Zip Code (the one which matches the billing address of the card) ___________.

Signature                                                                             .

Please print out this form and mail or fax with your credit card information or mail with a check made out to

Virginia Lloyd-Davies, 366 Mackeys Lane, Fairfield, VA  24435

fax: 540-261-1935

Allow 4-6 weeks for delivery

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