INSTRUCTIONS: Print this form out, fill in all the information, include check or payment information, and snail-mail it to 5 E. Eglin Blvd, Londonderry, NH 03053. Make check or money order payable to Rebecca Gallant. Please go to http://www.wildlife-fantasy.com to find the item you want and describe it below.

Please fill in all 
shipping information Buyers name:____________________________________________________

Recipients 
name (if different):_________________________________

Shipping 
address:_______________________________________________

City:___________________________________

State:____________

Country______________

Postal zip code:________________________

Phone# 
of buyer:________________________ E-mail of buyer:________________________

Please send me the following item(s):

The following items are only available from Cafe Press: Mousepads, Tile Coasters, Tile Boxes, Clocks, T-shirts with paintings on them, Coffee Mugs, Totebags, and Steins.

Describe your item here (name of picture, price, amount and size if applicable)

____________________________________________________________________________________________

____________________________________________________________________________________________

Shipping:
$22.50 for originals | $3.00 each for each print. | $1.00 for Notecards. | $3.00 each for Silscreened T-shirts.
2-Day shipping add $12.00 to any price above. Overnight add $22.50 to prices above.

Please choose shipping method:
Regular Mail_______ NOTE: I do not send originals through the U.S. Post Office.
UPS Standard______ | UPS 3-Day_______ | UPS Overnight _______

Please choose payment method:

Check _____ (payable to Rebecca Gallant) | Money Order _____ |

Credit Card_____ Card Number_______________________ Exp. Date_____/_____

Please fill in your total costs here:________________________