Canvasme.com Order Form

Print this page and mail it with your photo to:
 

Freewheel Inc., PO Box 85175
Hallandale Beach, FL 33008-5175

YES, I would like to order a picture on canvas from the photograph I am sending.  

Size [ ] 18” x 24”  ($199)   [ ] 10.5” x 14” ($149)  
Retouching [ ] Minor (free!)   [ ] Medium ($39) [ ] Major ($79)  
Change background, red-eye, color, brightness, contrast, sharpness, minor dust and scratches.   Change of skin tone and color, wrinkles, extra pounds, etc.   Change of hair style, clothing, add or remove people or objects, make-up, etc

Special Image Processing or Instructions, including background changes  (you may continue on the back)

 

 

Cardholder Information  

First name

 

Last name

 

 

 

Card type

o Visa

o MasterCard

o American Express

o Discover

 

Card Number

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Exp.

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Billing Address

 

 

 

Apt#.____________

 

City

 

 

State/ZIP

 

 

Telephone

Day

 

Evening

 

 

E-mail

 

 

 

 

 

Delivery Information

Shipping: Florida: $12, elsewhere in the USA or Canada: $22

[ ] Customer pickup

[ ] Same address as above

[ ] Send to:

First name

 

Last name

 

 

 

Street Address

 

 

 

Apt#.____________

 

City

 

 

State/ZIP

 

 

Telephone

Day

 

Evening

 

 

E-mail

 

 

 

 

 

I understand that:
- I must own all the rights of the picture I am sending.
- I will receive a framed picture on real canvas that resembles an oil painting.  This picture is not an oil painting but computer-aided art.
- The retouching process will eliminate certain level of detail from the original photograph and there may be color and intensity shifts.
- Delivery may take up to three weeks from the moment the original picture is received.
- Original photos will be returned with the final work.
- If we determine your picture needs more or less retouching than you estimated above, we will contact you to discuss the difference in price.

__________________________________________________________
Signature                                                                                      Date  

Hereby, I accept the terms of this order and authorize Freewheel Inc. to charge my credit card in the amount shown as Current Charges and I  agree to perform the obligations set forth in the Cardmember’s agreement with the issuer. I understand this order is subject to Additional Charges will not be effective until we obtain an authorization from you.