Order Form

Fungus Art Order Form

Print form, complete and mail or fax to: Fungus Art, P.O. Box 330, Carnegie, PA 15106 (412) 429-0964

These are not reproductions. Each fungus is shaped differently and is painted entirely by hand. The picture will be similar to, but not exactly as shown. Size may be slightly larger or smaller. Delivery will be few weeks to months. Often the fungus has to be found, picked and dried before painting can begin. Fungus Art guarantees a secure transaction by accepting payment only by mail or by fax.

Customer Name:
Address:
City, State, Zip:
Phone: E-mail:

Ship To Name:
Address:
City, State, Zip:

*__Check __ Money Order __Visa __ Master Card __ Discover Card*
*Please make checks and money orders payable to Larry Schneider

Card No: Exp. Date:
Signature: Date:

Item Description Price
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Sub Total:_______________________
*Continental United States.	*Add 12% for box, bubbles & shipping:_______________________
Other locations by quotation.	Total Enclosed:_______________________



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