Lasting Impressions Commission Form

Name

Address

City

State

ZIP

Phone

E-mail

Mark the box to place your order:

Portrait Medium

Flagstone - $150.00

Wood Slice - $150.00

Door Sign - $150.00

Canvas (8" x 10") - $200.00

Canvas (9" x 12") - $225.00

Canvas (14" x 18") - $275.00

Canvas (16" x 20") - $300.00

Canvas (18" x 24") - $350.00

You will be contacted via email at the address listed above. At that time, you will be given instructions as to payment of the deposit and submission of photographs. Thank you for your order!!!