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| Additional Address Line (if needed) |
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| Spirit of Freedom Poster ($25 each) |
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| Porcelain Plate ($20 each) |
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| Bronze Medallion in Lucite |
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| Coffee Mug ($15.00 each) |
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| Cap ($15 each) |
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| T-Shirt Black L($20 each) |
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| T-Shirt Black XL($20 each) |
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| T-Shirt Black XXL($20 each) |
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| T-Shirt Navy XL ($20 each) |
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| T-Shirt Navy XXL ($20 each) |
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| T-Shirt Navy XXXL ($20 each) |
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| Book: The Birth of a Monument (price
undetermined as yet) |
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| Model of The Spirit of Freedom ($10,000) |
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| Model of The Amistad Memorial ($7,000) |
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| Bust 1 from The Spirit of Freedom ($12,000) |
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| Bust 2 from The Spirit of Freedom ($12,000) |
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| Bust 3 from The Spirit of Freedom ($12,000) |
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| Bust 4 from The Spirit of Freedom ($12,000) |
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| Kentucky Residents: Add 6% Sales Tax |
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KY tax: |
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AMOUNT OF PURCHASE |
SHIPPING CHARGES |
| $1:00 - $25.00 |
$5.00 |
| $25.01 - $50.00 |
$7.00 |
| $50.01 - $75.00 |
$10.00 |
| $75.01 - $100.00 |
$15.00 |
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| Shipping Charges: |
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| Total: |
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| Method of Payment: |
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VISA
MASTERCARD
Money
Order |
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If paying by credit card: |
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| Name on Card: |
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| Card Number: |
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| Expiration Date: |
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If you prefer to send your order by mail, please print
out this form and send it, with your payment, to:
Ed Hamilton Studio, Inc.
543 S. Shelby St.
Louisville, KY 40202 |
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| Signature (if submitting form by mail): |
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| Comments about your order: |
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