The Greatest-Scapes Order Form

I am paying by:

Check or Money Order Enclosed

Visa

MasterCard

Card No. __________________________________ Exp. Date:________

Security Code: _____ (this is the 3 digit code on the back of the card)

Signature: _________________________________

Billing Address:

Name: ____________________________________

Street Address:______________________________ TEL: 1-800-786-3022

__________________________________________

City __________________ State ___ Zip________

Ship to Address (if different than Billing Address): Please mail your order to:

Name: ____________________________________ The Greatest-Scapes

Street Address:______________________________ P.O. Box 11548

__________________________________________ Pittsburgh, PA 15238

City __________________ State ___ Zip________

You can also Fax this Order Form 24/7 to: 1-800-519-3884

13” x 23” Framed Print	Qty	Price ea	Extension
Team Name:		$49.00
Team Name:		$49.00
Team Name:		$49.00
Team Name:		$49.00
Team Name:		$49.00
There is a one-time $6.00 discount shipping charge			$6.00
Grand Total

Thank you very much for your order!