David Adams Online ™ ORDERS PAID BY CHECK WILL BE SHIPPED WHEN THE CHECK HAS CLEARED
For credit card purchases, go online to davidadamsonline.com

Website: davidadamsonline.com E-mail: adamsonline@earthlink.net Name:________________________________________  Date of order:_________ Company (if applies)__________________________________________________ Street Address:____________________________________________________________  ___________________________________________________________________ City:_______________________________   State/Province: _________________ ZIP/Postal Code:___________________ Country:__________________________ Phone: _________________________  Evenings: _________________________ E-mail (for shipping confirmation): _________________________ Notice: We Do Not Share Customer Information!

Item Number	Title Of The Print or Painting	Quantity	Size in Inches	Price of Each	Item Total
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	Add $3.85 for retail orders within Continental U.S.A. For International orders outside the U.S. and Canada, add $10.00.			Shipping	_____
Make check or money order payable to David Adams. All orders outside the USA and Canada must be prepaid with International Money Orders.				Total	_____

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