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Please print out the form, fill in the details, and send it to the below address with your payment. We will confirm receipt of your order by e-mail.

          
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Address:  Phone:
                 
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(if different 
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City:  State:   Zip:  

Please be sure to fill out your physical address (shipping address) - UPS cannot deliever to a P.O. Box.

          
  Portrait
          Size

          
Number of Subjects
          in portrait

          
Price

          
Quantity

          
Total Cost
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

          
 Choice of Medium:

          
Pen & Ink Pencil Color Pencil Pastels

          
Mixed Media - Preference? ________________________
 
 
 
 
 
 
 
 

          
Comments, details, notes:

          
 

          
 

          
  U.S. Shipping
          - Free


          
Canada - $5.00

          
Total Shipping:
 
 

          
 NM Residents
          only: add 7.18% Sales Tax
 
 

          
50% Deposit Enclosed
 

          
Remaining 50%
          Balance Due
 
 
 

          
Total
 

Please make checks payable to Diane Gremillion
and include 50% Deposit/Balance with order to:

Diane Gremillion
P.O. Box 727
Ruidoso, NM  88355-0727

Note: Most portrait orders take 2 to 4 weeks to ship. Some backlog may occur around Christmas, so please order early.

Thank you for your order.  Orders will be promptly shipped.

    

Diane Gremillion
P.O. Box 727
Ruidoso, NM  88355-0727
505.257.5825  Fax: 505.257.2985
email:  dgremillion@zianet.com

 

      
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