Please note, this form is not a secure form at this time.

Customer Information

First Name:	Required
Last Name	Required
Address 1:	Required
Address 2:
City:	Required
State:	Required
Zip:	Required
Country:	Required
Daytime Telephone:	Required
FAX:
E-mail:

Orren Mixer Palomino Prints

Photo Orren Mixer Prints

All posters measure 20"x24".

Palomino Stallion with inset of Mare and Foal Poster $15.00

The Palomino Mare and Foal Poster $15.00

The Palomino Stallion Poster $15.00

Escape Poster $20.00 (Proceeds benefit Scholarship fund)

SPECIAL OFFER!

Order The Palomino Stallion, The Palomino Mare and Foal or Palomino Stallion with

inset of Mare and Foal Poster and we will include 1(one) FREE "Escape" poster!

Signed and numbered artist proofs and remarques are also available. Please contact PHBA for pricing.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Proceeds from the following items help benefit the PHBA Scholarship Fund.

Iron Horse Prints by Tena Coker

Iron Horse Print signed, numbered by Artist, $65.00 ($25.00 of sale benefits PHBA Scholarship fund.)

Palomino Coloring/Activity Book by Carolyn Henderson

Coloring Book Page3

Palomino Coloring Book $5.00 (All of the proceeds benefit the PHBA Scholarship fund.)

Personalized Paving Stone

Sample Paving Stone Photos

Stones are displayed at the PHBA office in Tulsa, OK.

4" x 8" Stone $50.00 6" x 12" Stone $75.00 12" x 12" Stone $100.00

Check item(s) ordering	QTY	DESCRIPTION	Our Price

		Palomino Stallion with inset of Mare and Foal Poster	$15.00
		The Palomino Mare and Foal Poster	$15.00
		The Palomino Stallion Poster	$15.00
		Escape Poster (Proceeds benefit Scholarship fund)	$20.00
		Iron Horse Print signed, numbered by Artist	$65.00
		Palomino Coloring Book	$5.00
		Paving Stone 4" x 8" Stone	$50.00
		Paving Stone 6" x 12" Stone	$75.00
		Paving Stone 12" x 12" Stone $100.00	$100.00

Paving Stone Orders Only: Type wording below exactly as you want it to appear.

Shipping and Handling Charges:

$0.01 - $15.00 add $ 5.00

$15.01 - $30.00 add $ 10.00

$30.01 - $45.00 add $ 15.00

$45.01 - $60.00 add $ 20.00

$60.01 & Up add $ 25.00

Shipping and handling charges above are for continental U. S. orders. All others will be at freight cost.

All fees above are the Discount for Cash and Check paying Customers.

Credit Card Information:
VISA OR MASTERCARD ONLY

CREDIT CARD NUMBER

NAME AS IT APPEARS ON CREDIT CARD

EXPIRATION DATE OF CREDIT CARD

LAST THREE DIGITS APPEARING ON BACK OF CREDIT CARD

Palomino Horse Breeders of America
15253 E Skelly Dr
Tulsa, OK 74116-2637
Telephone: 1(918) 438-1234

Fax: 1(918)438-1232

www.palominohba.com
E-Mail: yellahrses@palominohba.com

Last revised: May 02, 2008