Order Form
17
Merrion
Park
Blackrock
Co.
Dublin
Ireland
Tel/Fax:
+353
28833044
Email:
[email protected]
Website:
www.picturebloc.com
Please
complete
the
order
form
in
capitals
and
tick
desired
boxes,
use
one
form
per
image.
Please
read
our
terms
&
conditions
on
our
website
once
complete
sign
and
post
to
the
address
above.
Your
Details:
Name:
..............................................................................................................................................
Address:
..............................................................................................................................................
..............................................................................................................................................
Phone
No:
.................................................
Mobile
No:
...................................................................
E‐mail
address:
.............................................................................................................................................
Image
Selection:
(1) Using
your
own
photo
(2)
Gallery
Photo
Photo
code:
____________________
Post
CD
Post
Hardcopy
I
Will
Supply
My
Image
By:
E‐mail
Upload
to
Quick
File
drop
Box
E‐mail
prints
to:
[email protected]
Upload
to
File
drop
box
link:
https://picturebloc.sharefile.com/r-r0b75ec181b04a9ba Image
Adjustment:
None
Sepia
Warming
Filter
Black
&
White
Red
Eye
Reduction
Additional
adjustments
required
and
cropping
(please
specify)
___________________________________
______________________________________________________________________________________
Delivery
Details:
Ireland
UK
Rest
of
the
World
Delivery
Address
if
different
from
above:
......................................................................................................
………………………………………………………………………………………………………………………………………………………………….
Desk
Top
Bloc:
Portrait
Delivery
Cost
4
x
6
inches
(10
x
15
cm)
€35.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
5
x
7
inches
(12
x
17
cm)
€43.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
6
x
8
inches
(15
x
20
cm)
€55.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
8
x
10
inches
(20
x
25
cm)
€85.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
8
x
12
inches
(20
x
30
cm)
€100.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
10
x
12
inches
(25
x
30
cm)
€110.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
Delivery
Cost
Landscape
6
x
4
inches
(15
x
10
cm)
€35.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
7
x
7
inches
(18
x
13
cm)
€43.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
8
x
6
inches
(20
x
15
cm)
€55.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
10
x
8
inches
(25
x
20
cm)
€85.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€17.50
12
x
8
inches
(30
x
20
cm)
€100.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€17.50
12
x
10
inches
(30
x
25cm)
€110.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€17.50
Delivery
Cost
Square
3.5
x
3.5
inches
(9
x
9
cm)
€22.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
4
x
4
inches
(10
x
10
cm)
€27.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
6
x
5
inches
(15
x
15
cm)
€40.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
8
x
8
inches
(20
x
20
cm)
€65.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€14.75
Panoramic
4
x
12
inches
(30
x
10
cm)
€80.00
Delivery
Cost
Eire
€6.75
UK
€
9.75
Rest
of
World
€17.50
5
x
15
inches
(38
x
12
cm)
€105.00
Eire
€6.75
UK
€
9.75
Rest
of
World
€17.50
Prices
Include
VAT.
Order
Cost
(If
you
are
purchasing
more
frames
you
can
add
a
total
cost
on
the
last
order
form
and
pay
only
one
delivery
charge
which
will
be
the
largest
item
in
cost.)
Product
(s)
€
.................
Delivery
Charge
€
.................
Total
Order
Cost:
€
........................
Payment
Method:
Visa
Mastercard
Lazer
Card
Number:
Card
Expiry:
Card
Issue:
Security
Code:
(last
three
digits
on
back
of
card)
Card
Holder
Name:
________________________
Signed:
__________________________
Cheque
Bank
Draft
Postal
Order
(Cheques,
bank
drafts
and
postal
orders
to
be
made
payable
to
Picture
Bloc
in
Euro’s).
Paypal
paypal
account
holders
Send
to
[email protected]
If
you
do
not
have
a
paypal
account,
send
me
an
email
with
a
pay
by
paypal
request
(note:
paypal
charges
apply,
please
see
their
website
for
more
info)
Bank
Transfer
Bank
Transfer
in
Euro’s
made
payable
to
Picture
Bloc,
A/C
No:
1581
0364,
Sort
Code:
90
10
28,
IBAN:
IE
18
BOFI
9010
28158103
64,
Swift
Code:
BOFI
IE
2D,
Bank
Address:
Bank
of
Ireland,
Main
St,
Blackrock,
Dublin,
Ireland.
Additional
Requirements/Comments:
Should
you
have
any
additional
requirements
or
comments
please
detail
below:
...................................................................................................................................................................................
....................................................................................................................................................................................
....................................................................................................................................................................................
....................................................................................................................................................................................
Terms
&
Conditions:
I
have
read
and
understood
the
Picture
Bloc
terms
and
conditions,
please
process
my
order.
(T&C’s
can
be
found
on
a
link
at
bottom
of
web
homepage.)
Signed:
.................................................................
Date
...................................................
Thank
you
for
placing
your
order
with
Picture
Bloc.
Your
order
will
be
delivered
to
you
within
10
days.
We
hope
you
enjoy
your
unique
piece
of
contemporary
acrylic
art.