Commission art that Works for Life

Please fill out the form below to commission art that Works for Life.

Note: A $150 deposit is required for your commission.

Your Name:*
	Delivery Address
Street Address:*
Suburb:*
State:*
Post Code:*
Country:*
Phone Number:*
Mobile Number:
Fax Number:
Email Address:*
Child's Name:	(if applicable)
Child's Age:	(if applicable)
Theme of Artwork:*
Type of room where artwork will feature:*
Aspect of room where artwork will feature:	North North-East East South-East South South-West West North-West
Colours:*	Select Color Select Color Select Color Select Color Select Color
Would you like a Gold, Silver or Bronze accent?:
Preferences for a Collage: (Your fabrics may be posted to WFYH)	Beads Glitter Decorative Tape Ribbons Diamonties
Orientation of Canvas:*	Landscape Portrait
Dimensions of Canvas: (if known)	contact Sharron for help if required
Do you have a Budget?:	$250 - $500 $500 - $1000 $1000 - $2000 $2000 - $3000 $3000 - $4000 $4000 - $5000 $5000+
General Comments/Instructions:
	Note: Please send up to 5 photos of the room to assist me to get a better understanding of what you require, you can do so by emailing them to . If the photos are too large to email, you can use the free service at YouSendIt.com to get them to me.