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AFTER YOU COMPLETE THIS FORM CLICK THE SUBMIT BUTTON AND THE ORDER WILL BE SENT TO MAURICE.  ACKNOWLEDGEMENT WILL BE SENT BY EMAIL . ORDER WILL NOT BE SHIPPED  UNTIL PAYMENT IS RECEIVED .

TITLE OF PAINTING 
TITLE OF PRINT
PRICE 
SHIPPING /HANDLING
TOTAL INCLUDING SHIPPING /HANDLING
YOUR NAME
YOUR ADDRESS
YOUR CITY, STATE AND ZIP CODE
YOUR PHONE NUMBER
YOUR E-MAIL ADDRESS

 

  WALT COSTILOW
1629 CROSSGATE DRIVE
BIRMINGHAM, AL 35216
205-979-8198
E-Mail:  wltthr3@aol.com