Request for Commission
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Name
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First Name
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Area Code
Phone Number
E-mail
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Preferred Method of Contact
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Phone
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Best time to reach you...
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AM
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Preferred Art Materials
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Painting
Mixed Media
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Shipping Address (Free Shipping)
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Street Address
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Afghanistan
Albania
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American Samoa
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Angola
Anguilla
Antigua and Barbuda
Argentina
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Aruba
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Austria
Azerbaijan
The Bahamas
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Bangladesh
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Christmas Island
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Colombia
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Cuba
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Cyprus
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Democratic Republic of the Congo
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Ecuador
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Fiji
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France
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Iran
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Jamaica
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Jersey
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Laos
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Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
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Sri Lanka
Sudan
Suriname
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
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Tuvalu
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Ukraine
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Uruguay
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Vanuatu
Vatican City
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British Virgin Islands
Isle of Man
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Wallis and Futuna
Western Sahara
Yemen
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Zimbabwe
Other
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Size
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Please Select
36" x 48"
11" x 17"
40" x 40"
22" x 30"
Custom Size
I have specific color palette
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Please Select
Yes
No
I'm not sure
How did you hear about Nerissa Balland Art?
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Please share any specifics on the piece you wish to commission.
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