RETURN TO GALLERY

ORDER A LIMITED EDITION PRINT Please print out this order form using the print command within your internet browser. Once you have filled in the details requested, please post or fax the form to: Skylight Galleries PO Box 51343, Waterfront, Cape Town 8002, South Africa fax: +27 (0)21 251218 e-mail: skylight@iafrica.com

HOW TO ORDER Each print has a catalogue number and title. Please quote number and title plus the quantity when ordering.

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Method of payment :

VISA ........ Mastercard ........ American Express ........ Diners Club ........ Cheque ........ Money Order ........

Credit Card NO : |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| Card expires.............

Title ..................... Name ...................................................................................
Adress...............................................................................................................
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Postal code .......................................	Country.....................................................
Tel .................................................	Fax ..........................................................
e-mail..............................................
Signature.............................................................................................................
Allow 10 days approx for delivery