MAIN ORDER FORM
To order, print and fill out this order form
and mail with a check or money order to:
STEPHEN ALCORN
112 West Main Street
Cambridge, New York, 12816
If you need additional information, please don't hesitate to call or fax us.
Telephone (518) 677-5798
Fax: (518) 677-2526
stephen.alcorn@verizon.net
http://www.alcorngallery.com
Upon request, your purchase may be accompanied by a brief message of your choice (maximum 5 lines please).
Number of sets:__________________________________________Total Price $_________
Price per individual print: $6.00. Shipping and handling $3.00 for every 6 prints
International air postage $10.00
Number of individual prints:__________________________________________Total Price $_________
New York State residents, please add appropriate sales tax:___________
Note that all amounts are in US$.
Checks or money orders from outside the United States must be in US$ and drawn on a United States bank.
Orders will be shipped once checks clear.
Please specify the number and identity of individual prints being ordered. Thank you.
Iris ___________________________
Lily ___________________________
Tulip __________________________
Hosta __________________________
Phlox __________________________
Pansy __________________________
Zinnia _________________________
Poppy __________________________
Hyacinth _______________________
Foxglove _______________________
Hydrangea ______________________
Bird of Paradise _______________
For those interested in purchasing Stephen Alcorn’s original relief-block print/s,
kindly fill in name of print/s of your choice, and its respective price, within its corresponding category below.
MODERN MUSIC MASTERS
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
THE ARTIST OF THE MISSING: A Suite of Eleven Original Prints (sold individually or in complete sets of eleven)
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Complete set___________________________________________________ Price $_________
LITERARY THEMES
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
LITERARY PORTRAITS
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
ABRAHAM LINCOLN & HIS TIMES
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
FREDERICK DOUGLASS & HIS TIMES
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
IL BESTIARIO STRAORDINARIO
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
FOLKLORE
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
MODERN MUSIC MASTERS
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
PORTRAITS OF FAMOUS ARTISTS
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
MISCELLANEOUS PORTRAITS
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
SELF PORTRAITS/FAMILY
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Title of print___________________________________________________Price $_________
Shipping & handling for Stephen's prints $10.00 for one,
add an additional $5.00 for each additional print.
International postage $20.00 for the first item, add an additional $5.00 for each additional print.
Shipping $__________ Call or e-mail if you require specific shipping needs.
New York State residents, please add appropriate sales tax:___________
(BOTANICALS AND/OR RELIEF BLOCK PRINTS)
Note that all amounts are in US$.
Checks or money orders from outside the United States must be in US$ and drawn on a United States bank.
Orders will be shipped once checks clear.
We need to know where to send your order, so don't forget to provide your address!
Name ________________________________________________________________
Company _____________________________________________________________
Address _____________________________________________________________
City ________________________________________________________________
State/Zip/Country ___________________________________________________
Phone _______________________________________________________________
Fax _________________________________________________________________
E-Mail ______________________________________________________________
Call or e-mail if you require specific shipping needs.
Thank you for your interest in The Alcorn Studio & Gallery.