Payments can be made by certified check or money order to
"Art Originals by Diane" in Canadian Dollars.

Please provide the following information, and you will be contacted within 
24 Hours re payable taxes. Or call 1-905-579-1336 collect.

Choose Painting
Full Name:
Street Address:
City:
Province
State
Canada:
US:

Zip-Postal Code:
Country Other:

Day Phone:
Evening Phone:
Fax Number:
Email Address:
Your artwork will be shipped to you upon receipt of payment.