brownblackandwhite Order form

If you don't have access to a printer, please write (print) the following information and send with your check.
Otherwise you can print this form by clicking your print button in your browser and mail it to the address below.

Your Name:
The name of the desired image:
Street Address (P.O Box):
City:
State/Prov.
Country:
Zip Code:
Your Email:

Please make the check payable to: Richard Brown

Please send payment to: Brown Black and White
  PO Box 547
  Midland, Ontario
  Canada
  L4R 4K9

We will prepare the image for posting and forward the goods to you upon
receipt of payment.
We will also respond with an e-mail advising you of the date that the image
has been shipped.

And thanks for your order.