Order form for a Pet Portrait by ADAN CHINCHILLA
Adan Chinchilla, 1286 University Ave #121, San Diego, CA 92103
Phone: (619)807-8236 E-mail: adanchinchilla@aol.com
Please print out a copy of this form or email the information requested bellow. After completing the information, send it with your photos and check to me at the above address. Thank you very much for the commission. I know that I will enjoy spending time with your pet.
Order date: _____________________________ Date required by: _________________________
| Name:___________________________ | Ship to:__________________________ |
| Address:_________________________ | Address:_________________________ |
| ________________________________ | ________________________________ |
| City&State: ____________________Zip:__________ |
City&State: ______________________Zip:__________ |
| Phone:___________________________ | |
| E-Mail:___________________________ |
| Pet's Name(s): | Sizes: 5" x 7", 6" x 8", 12" x 10", 11" x 14" or 12" x 12" for $250.00 each | |
| Sizes: 16" x 20", 18" x 24", 20" x 20", 24" x 24", 24" x 32" or 22" x 28" for $350.00 each | ||
| Addt'l head @ $100.00 each | ||
| Dog | ||
| Cat | ||
| Horse | ||
| Shipping, Insurance(optional) to be paid by client.Price based on requested shipping method (Fed. Ex., USPS, etc.) | ||
| Packing: $10.00 per painting flat rate | ||
| Other | Check Number _________________ | TOTAL: |
| Check here if you paid using PayPal |
Dedication information: ____________________________________________________________
Special instructions: ________________________________________________________________
No. of photos sent with order: ______ SIGNATURE:
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adanchinchilla.com and all its images copyright Adan Chinchilla. All rights for reproduction remain with the artist.