First Name Last Name Address Line 1 Address Line 2 City State Zip Code Telephone Number () - E-mail Address Name of Original Oil Painting Giclee' Print Name Giclee' Print Order Number Print Size Number of Prints 2nd Giclee' Print Name 2nd Giclee Print Order Number 2nd Print Size 2nd Number of Prints Visa/Master Card Number Visa/Master Card Expiration Date Name on Visa Master Card Comments All order are subject to 6.5% Florida Sales Tax. Shipping charge will be based upon size.  Minimun Charge is $7.50. Please allow two weeks for shipping. Orders may be sent by mail.  Send check or Credit Card Information to: Mimi McCallum 2355 N.E. Ocean Blvd. Apt. 1B Stuart, Florida 34996 Telephone No. 772-334-3492 or Cell No. 772-341-1021 Fax No. 863-983-5484 E-mail Address: mimi@mimimccallum.com