zephyrblau ~ order form
image name
quantity
subtotal

1.________________________________________
 (Check selection)
Gelatin Silver Print 7-1/2" x 9-1/2" __________

Gelatin Silver Print 10-1/2" x13-1/2" __________

Resin Print 8" x 10" __________
_____
$__________.____

2.________________________________________
 (Check selection)
Gelatin Silver Print 7-1/2" x 9-1/2" __________

Gelatin Silver Print 10-1/2" x13-1/2" __________

Resin Print 8 x 10" __________
_____
___________.____

3.________________________________________
(Check selection)
Gelatin Silver Print 7-1/2" x 9-1/2" __________

Gelatin Silver Print 10-1/2" x13-1/2" __________

Resin Print 8 x 10" __________
_____
___________.____


Subtotal
___________.____
(If shipped to a California address, please add Sales Tax.)

CA Sales Tax
(8.5%)

___________.____
Shipping / Handling - (All orders shipped via insured USPS Priority Mail at no charge to the buyer.) No Charge
No Charge



Total
$__________.____

Ship To:
Name:
_________________________________________________
Address:
_________________________________________________
Address:
_________________________________________________
City, State, Zip:
_________________________________________________
Country:
_________________________________________________
Telephone:
_________________________________________________
Email address:
_________________________________________________

Payment must accompany order.
Make checks or money orders payable to "G.R. Haussler / Zephyr Blau" and mail completed order form with payment to:

Jerry Haussler
c/o Zephyr Blau
P.O. Box 685
San Mateo, CA 94401-0685

or fax form for inquiry to
(510) 583-8085

Thank you for your order!