C+M Address

MBean+Artpin Order Form
DATE:
Please fill out this form and a mail along with payment.
  DAY EVE
 

MADISON W. BEAN
Madison Bean

C+M PINHEADS
C+M PinheadsC+M Pinheads
C+M Pinheads
TITLE
QTY
PRICE
TOTAL
"Madison W. Bean"
$ 100.00
$
C+M Art Pin : "Cheeky Boy"
$ 20.00
$
C+M Art Pin : "Cabaret Emcee"
$ 20.00
$
C+M Art Pin : "Zippy Pinhead"
$ 20.00
$
SHIPPING INFORMATION:
Madison W. Bean = $7.75 each order
1 Art Pin = $2.10 / 2 @ $2.75
3 @ $4.25 / 4+@ $4.75
Art Pin order shipped with
Mr. Bean = no extra charge

PLEASE NOTE:
Artwork will be shipped via USPS upon
receipt of payment. Please make check or money order payable in US funds to Chris Chomick.
Thank you

Ship/Hand

$

FL Sales Tax

$

TOTAL

$


Chomick+Meder retains all reproduction rights after purchase unless otherwise agreed and stated. C+MWeb 11-21-07