Order Form

Date.............................                                                                                   ANNEMIEKE MEIN O.A.M.

                                                                                                                        PO BOX 1444

                                                                                                                        SALE

                                                                                                                        VICTORIA  3850

                                                                                                                        AUSTRALIA

ORDER FORM                                                                                               ABN 73 933 995 077

 

 Address of Buyer  ..........................................................................................

 

                              ..........................................................................................

 

                              ..........................................................................................

 

Email  ......................................................................................      Phone  .................................................

 

Number Limited Edition Prints Unit Price Total Price
            $           $
............ SPLASH! 145.00 ...............
............ SEA GAR 145.00 ...............
............ THORNBILLS (Artist's proof only)* 145.00 ...............
       
  Notelet Cards (with envelopes)    
............ DE LAPJES (Butterfly) 2.50 ...............
............ DIVING BLUE-BILLED DUCK 2.50 ...............
............ EUCALYPT BLOSSOMS 2.50 ...............
............ HERE SHE COMES! (Wren family) 2.50 ...............
............ THORNBILLS (Landscape view) 2.50 ...............
............ WHIRLPOOL FROG 2.50 ...............
............ DAMSELFLIES 2.50 ...............
............ SPLASH! (Frog) 2.50 ...............
............ MATING MYTHICAL MOTHS 2.50 ...............
............ DRAGONFLIES 2.50 ...............
............ FROG DOWN UNDER 2.50 ...............
............ HERE HE COMES! (Blue Wrens) 2.50 ...............
............ INSIDE LOOKING OUT (Butterflies) 2.50 ...............
............ SNAKE-NECKED TORTOISE 2.50 ...............
............ INVASION (Blowflies) 2.50 ...............
............ THORNBILLS (Portrait view) 2.50 ...............
............ AGAINST THE TIDE (King George Whiting) 2.50 ...............
............ LEWIN HONEYEATER NESTLINGS 2.50 ...............
............ SEA GAR (Garfish) 2.50 ...............
............ SHY (Weebill Chick) 2.50 ...............
    Postage ...............
    Total ...............
  • Please make out cheque or money order to Annemieke Mein (Australian dollars). Alternatively, payment may be made at www.paypal.me/AnnemiekeMein
  • Postage and Handling charges are free for delivery in Australia (Prints and/or Cards).
  • Postage and Handling charges for international orders AUD$10 per order (Prints and/or Cards)
  • Send completed order form to above address
  • *THORNBILLS available as un-numbered Artist’s Proof Print only - same size, same quality.

8/16

Back to Contents