J P Glover Fine Art / Art Order Form

Please print order form, fill in and fax or mail with payment or credit card information to:
J P Glover Fine Art
108 Lakeland Drive
Mars, PA 16046
724. 538. 3225 Tel
412. 538. 3225 Fax
john@jpgloverart.com
Credit Card Information
Name
Print/Painting Title Qty Cost Address 1

City

State

Country

Tel

Fax
Sub Total
Credit Card #
6% Sales Tax (PA only)
Type of Card
Shipping
Expiration Date
Total
Name on Card
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