TO MAKE A PURCHASE:     Before sending in payment, please e-mail  pauline@petalnfernimpressions.com  to reserve the piece you are interested in!  The selected artwork(s) will be reserved for  7 calendar days & shipped when payment is received.   Gift certificates in a pressed floral card are also available.

Print out the form below, complete the information, and mail with your payment.   Check or money order payable to:  Petal n Fern Impressions    Mail payment to:   P.O.  Box  242  Shrewsbury,  MA 01545    Master Card, Visa, and Discover accepted via phone order only.  Call 508-344-1342 to place a credit card order.

Shipping & Handling:   Please E-mail for exact amount!   *Separate pricing for shipments made outside the continental US.   Contact pauline@petalnfernimpressions.com for these rates.

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Original Artwork #  ____________   Picture Size:  __________  Plant Name:  __________________________

Check one of the following:   ____  Clear glass        ____ UV filtering; anti-reflective glass   Add $20 for 8x10    $30 for 11x14

Listed Art  Price:  $______  + Shipping & Handling (price determined via e-mail) $___ + Non-glare glass (if applicable) $________  =  $_________  (total)

(List additional artworks at the bottom of this form or print out separate forms for each order.)

Payment enclosed:    $ ______________    

Recipient's Information - Please print clearly!      If this is a gift,  please provide the greeting at the bottom of this form. 

A pressed floral gift card will be included with your purchase and a receipt will be sent to the name on the check or money order.

Name:       _____________________________________________________________________________

Street Address:  ________________________________________________________   Apt. # _________

City, State, Zip   ________________________________________________________________________