Order Form
Print this page to get a copy of the Order Form.  Email me at carolyn.jakes@sympatico.ca or phone (613) 752-2500 between 8am and 8pm Eastern Standard Time to obtain exact shipping costs.  Mail completed form with payment to

Carolyn Jakes
Artist
318 Kennedy Rd. Box 159
RR 2, Calabogie, Ontario
Canada
K0J 1H0

Ship reproductions to:

Name:
Address:

Postal Code:
Email:
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Date:
Prepayment by:

Bank Draft ___  or Postal Money Order ___
payable to Carolyn Jakes.
(no refund on shipping, handling and insurance.)
Item Description Quantity Unit
Price
Can$/
US$		 Total Price
001 Dancers
16" X 21.5"
Limited Edition
(run of 160)
signed & numbered		   80.00/ 51.00  
002 Dancers
7.5" X 10" signed		   25.00/ 16.00  
003 Dancers
note card
4.75" X 6.25"
unsigned		   2.50/ 1.60  
004 Dancers
note card
4.75" X 6.25"
signed		   5.00/ 3.20  
005 Dancers
box of 10 cards
unsigned		   22.50/ 14.25  
006 Dancers
box of 10 cards
signed		   50.00/ 31.60  
007 Eternity
16" X 16"
Limited Edition
(run of 200)
signed & numbered with gold paint added by hand		   75.00/ 47.50  
008 Eternity
12" X 12" signed		   30.00/ 19.00  
009 Eternity
note card
4.75" X 6.25"
unsigned		   2.50/ 1.60  
010 Eternity
note card
4.75" X 6.25"
signed		   5.00/ 3.20  
011 Eternity
box of 10 cards
unsigned		   22.50/ 14.25  
012 Eternity
box of 10 cards
signed		   50.00/ 31.60  
013 Gold paint added by hand to #008 or #010   2.50/ 1.60  
014 Paper copy of meaning of Christian symbols   2.50/ 1.60  
Ontario residents add 8% PST    
Shipping, handling, insurance
(email me first to obtain exact cost.)		    
Total