Pets on Glass Order Form Follow these easy steps to order!

Note: All of our work is professionally created, one at a time - no 'factory output'.
Please be patient. If you provide your email address as requested, we will keep you
up to date and let you know when your order has been shipped.
(Select "Print" in your browser to print this form.)

1. Find a favorite picture of your pet(s)
Put pet's name on back of picture (Artist will only use your pet's picture so people,
background, etc. won't matter) If picture has 'red eye', what is pet's correct eye color?__

2. Your Name: ________________________
Street/shipping address:_______________________
City: _________________ State: _________ Zip: _______
Email address:_______________ [So we can let you know when your glass has been shipped.]

3. Choose Stained glass edge color:

__Artists choose best match	__Aqua	__Pink	__Purple
__Blue	__Orange	__Red	__Yellow
__Clear with snowflake pattern	__White	__Lavender	Other color: We'll match it if we can! _________

4. Write check for payment

(Payable to Gary Shepherd)	cost ea	amount enclosed
A) Pets on Glass (4" picture, 6" overall):	$65.00	$ _____
B) Pets on Glass (6" picture, 9" overall):	$95.00	$ _____
C) Pets on Glass (8" picture, 11" overall):	$125.00	$ _____
D) Pets on Glass (12" picture, 16" overall):	$170.00	$ _____
Shipping: A)$10 B)$14 C)$18 D)$22	choose	$ _____
(NM only) add tax: A)$5.16 B)$7.49 C)$9.83 D)$12.17	choose	$ _____
TOTAL ENCLOSED:		$ ________

5. Mail this form, your check & pet's picture to: Shepherd Design Associates 740 Parkside Dr. NE Albuquerque, NM 87123	Our Email and phone: gary@shepdesignassoc.com (505) 296-1238
	Your Pet's picture will be returned to you with your stained glass.