3880 Stockton Hill, Suite 103 #300
Kingman, AZ  86409

928-897-9245

brushwork@fredlucasarts.com 

Mail In
Order Form

1.   PRINT THIS FORM
2.  FILL OUT
3. Write CHECK or MONEY ORDER
4.    MAIL TODAY TO:
                  FRED LUCAS ARTS
                  3880 Stockton Hill, suite 103 #300
                  Kingman, AZ 86409
Print Title Size Price  Quantity Total
         
         
         
         
         
         
SUBTOTAL        
SHIPPING USA orders $5/tube    
  International orders $15/tube    
ARIZONA SALES TAX for orders to AZ only 6.4%    
TOTAL        

For our records, how did you find Fred Lucas Arts?  __________________________________

BILL TO:  SHIP TO (if different from BILL TO):
NAME: __________________________________  
ADDRESS:________________________________
CITY: ___________________  STATE: _________ ZIP:____________ 
COUNTRY: __________________________
PHONE:_____________________________
          (include area code,  example:  123-456-7890)
E-MAIL:__________________________________		 NAME: __________________________________  
ADDRESS:________________________________
CITY: ___________________  STATE: _________ ZIP:____________ 
COUNTRY: __________________________
PHONE:_____________________________ 
         (include area code, example:  123-456-7890)
E-MAIL: _________________________________


Would you like to receive future information on new paintings and products as they are released?
Yes, send info via e-mail      Yes, send info via mail      No thanks
                          (your privacy is protected and used only for Fred Lucas Arts)

Click to go BACK to Fred Lucas' Home Page.