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Please print out this form and send it to us by fax or use this as a guideline on how to order by e-mail

HQ Group Co.,Ltd.
3/31 Samlan Rd, Tambon Phrasing, Amphur Muang, Chiangmai, 50200
Tel: (66 53 814 717-8) Fax: (66 53 814 719) Email: sales@hqartgallery.com
Your name:
  

Your address:

Important - must include postcode

  
Email address:
  
Telephone No.:
    
Fax:
  
Recipient's name:
(if different)


Delivery address:
(if different)

Important - must include postcode

  
Telephone No.:    
Name and price of paintings you wish to purchase:
(Note that we will calculate the shipping charge to add to this)
Code number
Painting name
 Price Total
       

Credit card payment by Visa, Mastercard or JCB. Don't use this form. We will explain how to send your cc details by a more secure method.

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