Print this form and complete the following information.

Winterberry Studio Order Form     

Name: ___________________________________________________________________

Address: __________________________________________________________________

City:   ____________________________________________________________________

State :____________________________________________________________________

Zip:  _____________________________________________________________________

Daytime Phone Number:  ___________________________________________

Evening Phone Number:   ___________________________________________

Email Address:  ____________________________________________________

Best time to reach you:_________________________________

How many Subjects:_____________

Subject Name(s):__________________________________________________________

Tell me a little about the subject(s):

What size Please Circle

What Medium Please Circle

 Additional Comments:

Please attach Photo and Deposit to this form. (Please do not staple ) And mail to:

Stephanie Carr ~Winterberry Farm Studio~ PO Box 126~ Chester, NH  03036

Thank you for your order