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HOW TO ORDER LIGHTHOUSE PAINTINGS

Print this page and mail your order to:

Frederic Kohli

33335 Irongate Drive

Leesburg, FL 34788

Phone/FAX: (352) 253-0337 - e-mail: fkohli01@comcast.net

ORDERED BY:

Name____________________________

Addr_____________________________

City______________________________

State______ ZIP____________________

Phone (____) ______ - ______________

e-mail___________________________*

SHIP TO: ( If different from "Ordered By)

Name________________________________

Addr_________________________________

City__________________________________

State_______ZIP_______________________

Phone (____) - ________________________

* (I will e-mail order acknowledgement & shipment notice)

FREE SHIPPING

in the contiguous USA                     See Price List    

QTY  LIGHTHOUSE         In-Stock      Custom Ptg   Size (W x H)      PRICE

___   _____________        ____            ___             ________       ________

___   _____________        ____            ___             ________       ________     

___   _____________        ____            ___             ________       ________   

___   _____________        ____            ___             ________       ________  

                                                    

                                                                                  Order Total  $            __

PAYMENT:  ____ Check or ____Money Order (Make payable to: Frederic Kohli

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