Chuck Clisso Photography Order Form

1. Shipping and Contact Information

*Fields in bold are required*

Name:

Email Address:


Address (line 1 required):



City:


State/Province:


Zip/Postal Code:


Country (If outside the US, contact chuck@clisso.com for shipping rates):


Phone Number (Include area/country code):

The above personal information will not be shared with anyone.


2. Your Order

             Title:
Print #1

Print #2

Print #3

Print Dimensions:




 		Cost:
$

$

$


Title
The title of any print can be found directly underneath its small image within the appropriate online gallery. If the picture is untitled, please type what is written below the image for identification purposes.

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Dimensions
All prints are available in the following dimensions unless otherwise noted:

8"x10" print, 11"x14" mat
11"x14" print, 16"x20" mat
16"x20" print, 20"x24" mat

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Cost
The costs for prints in the standard dimensions are as follows unless otherwise noted:

8"x10" print - $175
11"x14" print - $225
16"x20" print - $275

All prints are archivally printed, archivally matted, numbered, and signed by the artist.

Shipping (free within US):
$

Total:
$

3. Payment

Please select a payment method:

Check or Money Order

Paypal (secure credit card payment online - Visa and Mastercard accepted)

If paying by Check or Money Order, simply complete this form and send your payment to:

Chuck Clisso Photography
P.O. Box 3107
Wise, Virginia 24293

If paying online with paypal, complete this form and follow the instructions on the following page.

Orders will be shipped upon receipt of payment and should arrive within 2 weeks.

Additional Information & Comments:

Please double check the above information and click the submit button only once. An email confirmation will be sent to you once your order has been recieved. You may want to write down your order total, as you will need to remember it for payment with paypal. Questions should be directed to chuck@clisso.com