Sold To:	Name:
	Street Address:
	City, State, Zip:
	Telephone:
Ship To:	Name:
	Street Address:
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	Telephone:
Please Check Payment Method:
				Check		Money Order		C.O.D.
				(US Mail)		(US Mail)		(Email)
Style#		Description					Unit Cost	Qty	Subtotal
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								Subtotal
Please Email C.O.D. Orders To:					CA Resident add 9.75%			Tax
mail@westcoastgallery.com					Add $30 per Panel			S & H
								Total
Please Send Payment To:
West Coast Gallery
4113 Nipomo Avenue
Lakewood, CA 90713