Please print out this Order Form, fill in the relevant details and post it
with your cheque for the amount of the products ordered to the address at the bottom.

KILIBARDA ART ORDER FORM Please use BLOCK captials to fill in this form Name : ................................................................. Email Address : ....................................................... Address : ............................................................... ............................................................................ City : ............................... Zip/Post Code : ............... Country : ............................................................... Please TICK the box/es below of the images that you require. Limited Edition Prints Image No : 001 Price $115.00 Image No : 002 Price $115.00 Image No : 003 Price $115.00 Image No : 004 Price $115.00 Image No : 005 Price $115.00 The above prices include Postage and Packaging ( Shipping and Handling ). Once you have fill in this Order Form, please make out your cheque for the full amount of your order, payable to 'G Kilibarda' and post them both to : Kilibarda Art Dovecote Farm Rudry Road Lisvane Cardiff South Wales U.K. Thank you for ordering prints from Kilibarda. Your prints will be dispatched as soon as your cheque has cleared the bank.

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