| Name:_________________________________________________ |
| Address:_______________________________________________ |
| City:______________________ State:_________ Zip:___________ |
| Phone:____________________________ |
| Order: |
| Qty Item Description Price |
| _______________________________________________________ |
| _______________________________________________________ |
| _______________________________________________________ |
| _______________________________________________________ |
| _______________________________________________________ |
| Sub-Total: __________ |
| Shipping*: __________ |
| Tax(ME residents): __________ |
| Total: __________ |
| Payment Information: |
| ______Check Enclosed payable to Maine Lighthouse Museum or |
| ______Charge to my Visa or MasterCard |
| Card #:________________________________________Exp. Date:___________ |
| Signature:_________________________________________________ |
*Shipping charges for each print is $50 for unframed and $250 for framed and includes insurance.
Mail to:
Maine Lighthouse Museum
P.O. Box F
Rockland, ME 04841
Ph: 207-594-3301