Kim Diment · 2292 Murray Drive · Grayling MI 49738

Before ordering, please contact Kim at the address above, E-mail  or call Kim at 989-344-1843
If you would like to make a purchase, please make sure you have reviewed all the information about the item (s) so that your order can be accurately filled.
When your order is successfully submitted you will see a Confirmation page.

Ordered by

Address

City/State/Zip

Ship To

Address

City/State/Zip

QUANTITY

ITEM DESCRIPTION

COST

Sub-Total

Michigan Residents Add 6% Sales Tax

Shipping Charges**

Total of Order
Indicate One Check/Money Order enclosed (if mailing this form)
Visa   MasterCard (if Charging, fill in information below or call with number - I recommend that you call with your charge card information.)
Make checks payable to Kim Diment

*For Credit Card Orders:

     Card Number  - - -     Exp. Date

Signature (if printing this form)__________________________________________

**Shipping:  $10.00 for any Print(s)

**All Prints are shipped flat. For orders of Originals, or  Sculptures, the actual shipping charges will be added to your invoice.  If you prefer, for SECURITY reasons, you can send your order by mail (print this form), or order by telephone by calling  (989)-344-1843.

REQUIRED - Tell us how to get in touch with you:

Name

E-mail

Tel

FAX

Please contact me as soon as possible regarding this matter.

Kim Diment
Copyright © 2010 [Wildlife Dimensions]. All rights reserved.
Revised: June 21, 2010 .