Place Your Order

If you have any difficulty in sending your order, or if you have any questions, feel free to email Larry at: lsarepro@comcast.net. Thank you!

Fax: (302)-999-9622
-or-
Mail: L.S. Anderson Reproductions, Inc.
2900 Faulkland Road
Wilmington, DE 19808

This Print Only Form is for those wishing to order by fax or mail.

Billing Information

Name:

Company Name (If Applicable):

Street Address:

City:

State:

Zip:

Phone:

Fax:

Shipping Information

Name:

Company Name (If Applicable):

Street Address:

City:

State:

Zip:

Phone:

Fax:

Order Details

Item 1. Name of Print:

Print Code:

Size :

Qty:

Price:

Item 2. Name of Print:

Print Code:

Size :

Qty:

Price:

Item 3. Name of Print:

Print Code:

Size :

Qty:

Price:

Item 4. Name of Print:

Print Code:

Size :

Qty:

Price:

Shipping & Handling:
Shipping and handling is a flat rate of $9.95. International orders are 19.95.

To reduce cost, if you live locally you may wish to contact Larry to arrange pick-up.
Check here if you would like to arrange purchase pickup:
Total Purchase Price Including Shipping & Handling:

Payment Options (check one):
Visa Card No: Expiration Date (mm/yy):

Mastercard Card No: Expiration Date (mm/yy):

Check Enclosed (Ordering by mail only)

Your Signature: ______________________________________

Your Email (for order verification):


	Please Print, Sign and Send by Fax or Mail