Anyone wishing to mail an order enclosing a photo which will be returned with your puzzle, use the order form below.

FILL OUT COMPLETELY. UPON COMPLETION OF THE FORM YOU MUST PRINT TWO COPIES, one to send to us and one for your records. If you are paying via Credit Card double check the card account numbers before closing the envelope. We accept VISA, MASTER CARD, and Personal Checks.

Photo Puzzle Item Number 005......................Cost $18.95 each plus Shipping and Handling

                                                                        SHIPPING & HANDLING

Order total = $18.95.......................................$8.55

Order total = $19.00 - $37.90........................$10.55

Order total = $38.00 - $56.85.......................$11.55

Order total = $57.00 - $75.80........................$12.55

ALL SHIPPING PRICES ARE DELIVERED TO SAME ADDRESS

Order totalling more than $75.80 please contact us for shipping total.

NAME/NAMES ON PUZZLE

PRIMARY COLORS ONLY

BILL  TO:
SHIPPING ADDRESS IF DIFFERENT THAN BILLING
SHIPPING
TOTAL PUZZLE COST
 CHECK
 MASTER CARD
  VISA
 SIGNATURE REQUIRED   ___________________________________________Phone#                                             
CREDIT CARD ACCT#                    EXP. DATE Example (01/08)

Mail to this address:   AVW                                Phone # 937-320-0950

                                       P.O. BOX 177                               E-MAIL

                                       ALPHA, OHIO 45301

TOTAL COST
FINISHED PRODUCT WILL APPROXIMATE ORIGINAL PHOTO SENT. SMALL CHANGES MAY BE MADE TO ENHANCE APPEARANCE

ORDER FORM FOR MAIL-IN PHOTOS