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U.S. Mail - Order Form

 Jalyn Photography
  Diana L. Jacobson
  1021 Harbour Court
  Wheeling, Illinois  60090 
  USA

Name:________________________________________________________

Address:______________________________________________________

City, State, Zip:_________________________________________________

Email Address:  ________________________________________________

Area Code,
Telephone:(_____)__________ (in the event there is a question about your order)

 
Print # Title Size Price
       
       
       
       
Shipping (if applicable)    
Total   

Upon receipt, your order will be acknowledged via email. Your order will be shipped within 10 business days after acknowledgment.

Condition of Sale: All prints are copyrighted by the artist with all rights reserved. Your signature below certifies that any and all prints are purchased solely for your private use and will not be reproduced or  used for any commercial purpose.

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Date                  Printed Name                    Signature