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Creative Names and N is for Name
Payable to: Barbaras Painted Designs
6 Barnsley Crescent
Mt. Sinai, NY  11766

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Shipping Information
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Art Background - $5.00 each plus $3.00 Shipping fee

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Please check one:   () Female    () Male
First Name
Art Background


Please check one:   () Female    () Male
First Name
Art Background


Please check one:   () Female    () Male
First Name
Art Background


Please check one:   () Female    () Male
First Name
Art Background


Please check one:   () Female    () Male
First Name
Art Background


Number of Items Ordered X $5.00@ =Sub Total  
$3.00 for first item, $2.00@ additional item = Shipping Amount 
NY residents please add 8.75% sales tax 
Total Enclosed