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“International Fine Art for Unique Collectors”

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Order Request Form

Fill out the requested information, and then let us know how to contact you

for follow up. Please note that all of our art pieces are unique and may not

be available at the time of your order. * Price will be communicated upon request and if the piece ordered is still available at the time of ordering. Please contact us for more info.

All sales are final.

Artistic Category	Item Description	Artist Name	Price*
Painting (This is an example)	"La Penseuse" (This is an example)	Claire Di (This is an example)	$xxx.xx (This is an example)
--	--	--	--	--
--	--	--	--	--
--	--	--	--	--
--	--	--	--	--
			Total cost of items	--
			Shipping & Handling Costs	--
			Insurance Cost (If applicable)	--
			State Sales Taxes	--
			Total Cost	--

NOTE: Shipping and Insurance Cost as well as State Sales taxes may apply to your purchase. The final price for each artistic piece ordered will be submitted for your approval before the order is complete.

By using this site and/or its services, you agree to abide by our User Agreement.

I read and agree with the terms of Art of Heart's User Agreement.

Special Comments & Inquiries:

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Bill to:

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Last Name	_______________________________
Title	_______________________________
Company	_______________________________
Address **(Please include City, State/Province, Postal Code, and Country)**	_______________________________ _______________________________ _______________________________
E-mail	_______________________________
Phone	_______________________________
Fax	_______________________________

Ship to:

First Name	_______________________________
Last Name	_______________________________
Title	_______________________________
Company	_______________________________
Address **(Please include City, State/Province, Postal Code, and Country)**	_______________________________ _______________________________ _______________________________
E-mail	_______________________________
Phone	_______________________________
Fax	_______________________________

Please indicate which way you will prefer Art-of-Heart to reach you regarding your inquiry:

_________________________________________________________________

Thank you for using our site and services. Art of Heart will respond to your request as soon as possible.

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