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PRINTS ORDER FORM
Print this form and indicate purchase(s).
Send check or money order to:
GALLERY ON WHEELS
62 Pheasant Ridge Drive
Loudonville, New York 12211-1524

LIMITED EDITION Lithograph Prints

Check Purchase	Price	Title	Size
	$42.50	WINTER VILLAGE	18" x 24" **
	$42.50	UPSTATE BIRCHES	18" x 24" **
	$38.00	COWS III	16" x 20" **
	$20.00	WHITETAILS ON THE WATCH	15 3/8" x 22" *
	$20.00	MALLARDS SPLASHOFF	15" X 22" *

OPEN EDITION Lithograph Prints

Check Purchase	Price	Title	Size
	$25.00	PIGS	16" x 20" **
	$12.00	WINTER VILLAGE	18" x 24" **

OPEN EDITION PRINTS by DiAnne Tracy

Check Purchase	Price	Title	Size
	$30.00	LOONS ON THE LAKE	11" x 14"**
	$40.00	CARRIE'S TOYS	16" x 20"**
	$40.00	ITSY BITSY SPIDER	16" x 20"**
	$30.00	BACK DOOR FRIENDS	11" x 14"**
	$40.00	THE LUNCH CROWD	16" x 20"**
	$35.00	PEACEFUL SNOW	10" x 20"**
	$30.00	TREE ORNAMENTS	11" x 14"**
	$40.00	THE GRAPE VINE	16" x 20"**

* image size
** overall size which includes border
Prices include shipping.
All prints are unframed.
N.Y.S. residents must add required sales tax for delivery address.

How may we get in touch with you:

Telephone:  (_____) _____-____________

       FAX:  (_____)______-____________

E-Mail Address:  ____________________

SHIPPING LABEL

NAME________________________________________

ADDRESS_____________________________________

CITY_________________________STATE___________

ZIP CODE_____________COUNTRY_______________