Moonbug Studio Portrait Order Form: Lynn Van Couvering, 1630 Williams Hwy., #240, Grants Pass, OR 97527 lynnvc@gate.net
Sorry, I am currently not accepting portrait commissions due to an extremely long waiting list. Please check back!

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Print this form, fill it out, and mail with your  photos today.  Please refer to the price list, and include a check or money order for 50%, payable to Lynn Van Couvering.  Use a separate form for each portrait.

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Name:

Address:

City, State, ZIP:

Phone:

E mail address:

Portrait size:

Subject's name:

Number of subjects to be in portrait:

Comments, notes, details:

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

 

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Medium:  (Check your choices)

Colored Pencil

Graphite

One color pencil (specify)

Pen & Ink

White Paper

Colored Paper

 

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Price (see price list)........................................................	__________
Shipping and handling....................................................	$15
Shipping outside Continental U.S. add $20....................	__________
Total................................................................................	__________
50% Deposit Enclosed....................................................	__________
Remaining 50% Balance Due (C.O.D.)...........................	__________
Signed_______________________________________
Date________________________________________

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Please send clear, sharp, close-up photos, on which the head is at least the size of a quarter, and details are clearly visible.  Professional photos must be accompanied by a copyright release from the photographer or studio.  Please use a photo mailer or other sturdy envelope to mail your photos, and ask for insurance from the Post Office when mailing valuable photos, or send good quality copies instead. 

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Please mail your order to, and make checks payable to: Lynn Van Couvering, Moonbug Studio 1630 Williams Hwy., #240, Grants Pass, OR 97527.

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The artist reserves the exclusive right to reproduce the artwork resulting from this agreement for resale/display purposes.

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Tee Shirt Orders 

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 Tee Shirt prices = $15 x 2, or $17 x 1 for each design and color.  You may mix sizes.

Quantity	Design	S	M	L	XL	Price	Ext.
	Critters/white
	Critters/daffodil
	Gator Eye/white
	Gator Eye/green
						Subtotal
						S/H
						TOTAL

 Please mail your order to, and make checks payable to: Lynn Van Couvering, Moonbug Studio 1630 Williams Hwy., #240, Grants Pass, OR 97527

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Return to Moonbug homepage e mail (lynnvc@gate.net)  if you have trouble with this form.  This is not an interactive form (yet).  Please print the form, fill out, and mail with your check or money order, or e mail your order.