To order this limited-edition photograph, send this form and a check or money order for $175 (which includes shipping and handling) to:
Carren Strock
c/o LRC Publications
1380 East 17 Street, Suite 2233
Brooklyn, New York 11230-6011
I would like my photograph in: [] a chrome frame []a natural light wood frame
Please send my photograph to:
Name:
Address:
City/State/Zip:
(US orders only)
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