Print out this order form

Send completed form and check or money order to:

LAMBERTVISION

451 S. HARVARD #324

LOS ANGELES, CA 90020

_____________________________________________

   13" BY 19" PRINT ORDER FORM

MAKE MONEY ORDERS & CHECKS PAYABLE TO RAYMOND LAMBERT

Name of print(s) 1._______________________ $16.00

2._______________________ $30.00. . . . . .buy 2 save $2

3._______________________ $44.00. . . . . .buy 3 save $4

4. _______________________$55.00. . . . . .buy 4 save $9

Date __/__/__

SHIP TO:

Name___________________________________

Address_________________________________

City______________________State____________Zip____________

Country_______________________

e-mail________________________

phone________________________

SHIPS DAY AFTER PAYMENT IS RECEIVED (U.S. MAIL)