| Print out this form and send to:
PO Box 42114, London SW8 3YW with your photograph(s), and a cheque made payable to Catherine Williamson All photographs will be returned including an receipt with your painting |
| Your name: Address: |
| Daytime telephone: Evening telephone: Email address: |
| Size of painting required: 13 x 18 cm 24 x 30 cm 30 x 40 cm Other: |
| Preferred delivery date: |
| Total amount of cheque paid (including £5 postage and packing): |
| Total number of photographs sent: |
| Delivery address (if different to above): |