Your Fax:

   Tom Costello       62 Knowsley Road       Cressington Park    Liverpool L19 OPG     England

 Tel: (UK)  0151 427 1444                                                     Email:



You may print this form and post your order with payment to the address above

            Alternatively you may order by post on your headed notepaper

             Electronic bank transfer orders may also be made by email or phone



Purchase Order Form

Handmade Prints

To order handmade images please print, complete and post this form. Cheques etc. should be made payable to Tom Costello and sent to the address above. Use of this form is not essential to provide the details we need 


Delivery Address

Title: Mr. / Mrs. / Miss. / Ms. / Other
First name / Initials / Last name:   
Address (1st line):  
Address (2nd line):  
Address (3rd line):  
Post code / Zip:  
Telephone Number (Day):  
Telephone Number (Evening):  
Email Address:  

No information will be released by us to any third party unless required by law.

Order Details

Image Title Quantity Price
//////////////////////////////////////////////////////           Sub-total:  
Plus non-£UK cheque conversion charge                    Add:  
*Your signature:   Gross Total :  

 Please use plain paper to extend order.


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