"If You Live to One Hundred" Custom Order Form
If you need help filling out this form online please contact me on my cell, 302-463-5459, and I will be glad to help you!
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Payment Type: Credit Card Payment through PayPal Check or Money Order
Please note that hitting "Submit" will send this information form to the artist's e-mail to begin processing the custom piece. To avoid any confusion, please do not hit "Submit" unless you are certain you have the order details finalized and your intention at this time is to actually place and pay for an order.