Name:____________________________ Address:________________________
City:_____________________________ State:____________ Zip:____________
Home Phone:______________________ Work Phone:_____________________
Email Address:____________________________________________________
Submit several non returnable head-on photos of your buck. A CD would be accepted
with several head-on digital files. Digital images will be accepted via email depending
on the size of the file. For photo insert into the the corner of Your Buck, please be sure
that your image is sharp to transfer. Please mark your photos with your name, address
and telephone number on the back of each photo.
Aditional Antler information needed to complete painting order.
Outside spread measurement:_____________________________
Number of points on left antler:_____________________________
Number of points on fight antler:____________________________
Distinctive character or unusual point not seen in photo:__________
____________________________________________________
Circumference of antler at base:____________________________
Nameplate Information:
Your Name:_________________________
Date of Harvest:______________________
Oil Painting of your antlers on Your Buck: $595.00 for a 22x28" or $395.00 for a 18x24"
Solid Oak Framing with linen liner: $145.00 for a 22x28" or $95.00 for a 18x24"
Personal Photo Insert with you and Your Buck: $100.00
A first payment of $250.00 must accompany this order form. Balance is due at the
time of completion of you painting. We accept MasterCard, Visa, American Express
and Discover,Personal Checks and Money Orders.
Payment Included
Check:____________________________
Credit Card:_______________________________ Expiration Date:________
CVN #:___________
Please print form then fill out required information and send to:
Jack Paluh Arts, Inc.
2869 Old Wattsburg Rd.
Waterford, PA 16441
814-796-4400 jpa@jackpaluh.com