Jocelyn Galsworthy Order Form

ORDER FORM - Limited Edition Prints

Please print-off this form, fill in and send to the address below Date of Order: ...../....../......

Print Edition No	Title	Order Quantity	Price Per Print	Total Cost
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	* UK POSTAGE (SPECIAL DELIVERY) & PACKING 1 to 5 Prints = £10.00 (Overseas postage - please contact prior to ordering)		TOTAL	£..........
			*POSTAGE & PACKING	£..........
			GRAND TOTAL	£..........

Delivery Address
Name:	.....................................................................
Address:	..................................................................... ..................................................................... ....................................Post Code...............
Telephone:	Home: Office:	................................................. .................................................
Signature	.....................................................................

Cheque or Card Holder Address (if different from address opposite)
Name:	.....................................................................
Address:	..................................................................... ..................................................................... .....................................Post Code...............
Telephone:	Home: Office:	................................................. .................................................
Signature	.....................................................................

Visa/Mastercard (by post or telephone)

I authorise you to debit my Visa/Mastercard account with the amount of: £............
Visa/Mastercard No:	.....................................................................
Expiry Date:	........../............/.............................................
Name (as on card):	.....................................................................
Signature	.....................................................................

Cheques and postal orders should be made payable to:
JOCELYN GALSWORTHY

Mounting and Framing can be arranged at a cost of £110 per print for larger editions and £50 per print for smaller editions

If you were directed to this site by a link from a cricket club site, please tell us which one. ............................................Cricket Club

Completed Order Forms should be sent by post or orders telephoned to the artist AT ANY TIME (details below):

The Artist
Jocelyn Galsworthy, The Studio, 39 Latimer Road, St. Helens, Isle of Wight, PO33 1TG
Email: CLICK HERE TO EMAIL THE ARTIST
Tel: 01983 873741 Mobile: 07885 542652 Fax: 01983 874182