Custom Portrait Order Form
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
Date
-
Month
-
Day
Year
Portrait Desired:
*
SIZE
MAT
NUMBER OF FIGURES
Portrait Desired
8" X 10" - $235
11" X 14" - $265
16" X 20" - $295
20" X 30" - $395
22" X 32" - $495
None = $0
Single = + $22
Double = + $ 36
1 = +$0
2= +$100
3= +$200
4= +$300
5= +$400
Notes or Special Instructions
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*
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