Artist Account Information

Please fill out the following form and print on your printer and mail  along with your photos, slides, transparencies, file disk, or original work to:

ImageSpirit Reproductions
137 Ridgewood Pl.
Marion, VA 24354

Please provide the following contact information:

Name
Business
Street Address
Address (cont.)
City
State
Zip
Work Phone
Home Phone
FAX
E-mail
URL

Please provide the following information about your art work.

Item # Title
Shipping Address- If different from contact address

Preferred Shipping: UPS     Priority Mail
Street Address
Address (cont.)
City
State
Zip
BILLING
Credit Card
Cardholder Name
Card Number
Expiration Date

Please Press Print Button at top of  page or go to file-print.