ORDER FORM FOR RELIEF-BLOCK PRINTS

To order Relief-block Prints 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, 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).


STEPHEN'S RELIEF-BLOCK PRINTS

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 $_________

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 $_________

SUB-TOTAL: $_________________

Shipping & handling for Stephen's prints $10.00 for one,
add an additional $5.00 for each additional print.

International air 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:___________

GRAND TOTAL: $_________________

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.