Bert Stern's Request and On 1st Order Form

Check all that are applicable:

Marilyn in Vogue, 20" x 24" silver print, edition of 25: $4,000.00
Roy Lichtenstein Paper Plates, package of 10 plates: $500.00

If you wish further information, want to order something, or simply leave a comment or suggestion please fill out the following. Click on the "Submit Form" button when you have finished.

- Your Name
- Company Name
- Position / Title
- Address
- Telephone Number
- Fax Number
- E-mail Address

Specific requests and comments:

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Bert Stern
330 East 39th Street, #32G
New York, N.Y. 10016
E-Mail: bert@bertstern.com
WWW: www.bertstern.com

Last Updated: November 4th, 1996