CANVAS MURALS  by Gerhard & Bambi Mounet -Lipp  (801) 979-4278

                                                Order Form

   To order your custom mural please send specific dimensions, possible pictures of the site

   where the painting will be - so we get a feel for the place.

   Any special requests, ideas or pictures which you would like to see included in the painting,

   ML Mural Art, PO. Box 183, Midway, UT 84049. 

Your Name:________________________________________________________________

Shipping Address:___________________________________________________________

City, State, ZIP:_____________________________________________________________

Day Phone:____________   Evening Phone:___________   E-mail:______________________________

Please specify your order

                                                   Utah resident? Please add 6.% sales tax

Orders from within the U.S. may be paid by check or money order. Orders from outside

the U.S.  must be paid in U.S. dollars by international money order only.  

Please make your check out to ML Mural Art

                                                          Thank you for your order!