Captain John’s Nautical Photos and Framing

3723 Bay Road

Erie, Michigan 48133

Phone: (419) 304-1801 – (734) 723-7475

E-mail: jachinger@aol.com

 

Mail Order Form

 

 

1.                  Product Description________________________________________

 

2.                  Product Number      ________________________________________

 

3.                   Size: (circle one of the following)      

picture size

fits frame size

        price

 

5 by 7

8 by 10

$14.95

 

8 by 10

11 by 14

$19.95

 

11 by 14

16 by 20

$24.95

 

13 by 19

18 by 24

$29.95

 

 

 

4.        Frame: (circle one of the following – if desired) 

frame size

 

        price

 

8 by 10

 

$8.00

 

11 by 14

 

$10.00

 

16 by 20

 

$20.00

 

18 by 24

 

$25.00

 

     Choose a frame color by placing a checkmark next to

     Color:    Standard Oak (  );      Blue Metal (  );      Red Metal (  );      Silver Metal (  )

 

 

5.      Decorative Matt:  (circle one – if desired)

matt for frame size

 

        price

 

8 by 10

 

$2.00

 

11 by 14

 

$3.00

 

16 by 20

 

$4.00

 

18 by 24

 

$5.00

 

Choose a matt color by placing a checkmark next to

Color:      Charcoal (  );    Dark blue (  );    White (  );    Red (  );   Dark Green (  );

               Tan (  );   Light Blue (  );   Light Green (  );   Cream (  );   Gull Grey (  );

 

 

6.            Quantity ___________________________________________________

 

7.            Comments _________________________________________________

 

                           _________________________________________________

 

                       

8.            Your Total: (total of all items – shipping charges and sales tax are already included in all prices)

$___________ ._____


 

 

9.            Money Order / Official Bank Check Payment – Make payable to:

 

Captain John’s Nautical Photos and Framing

 

OR

 

 

10.     Credit Card Payment: (circle one of the following)

    

Master Card

 

Visa

 

            Card Number  __  __  __  __  __  __  __  __  __  __  __  __  __  __  __  __

 

             Expiration Date: (circle the month and year)

January

2004

 

February

2005

 

March

2006

 

April

2007

 

May

2008

 

June

2009

 

July

2010

 

August

2011

 

September

2012

 

October

2013

 

November

 

 

December

 

 

    

Please Note: As an added security measure, for your protection, we ask that you enter the last three digits found in the signature block on the back of your credit card:

 

                 ___   ___   ___

 

 

    11.   Card Holder Name: ___________________________________________

 

            Address: ___________________________________________________

 

            City, State, & Zip Code________________________________­­­­________

 

 

 

  1.   Shipping Address:

 

Name: _____________________________________________________

 

Address: ___________________________________________________

 

___________________________________________________________

 

             City, State, & Zip Code: _______________________________________