Your Story in Art Name * First Name Last Name Recipient's Name (If Different) First Name Last Name Recipient's Nickname(s) Recipient's Age (if under 18) Please indicate * They/Them She/Her He/Him Pronoun not listed: will clarify in request Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Billing Address (If Different) Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Package of Interest * Your Story in Art Package A: Custom one-on-one art experience on Zoom with artist Shanna Israel using client's favorite themes and/or personal memorabilia + finalized art piece signed by Shanna. Your Story in Art Package B: Custom one-on-one art experience on Zoom with artist Shanna Israel using client's favorite themes and/or personal memorabilia + finalized art piece signed by Shanna + personal story/theme/art transformed into virtual art + up to 10 family shoutouts/photo montage. * Additional people for Zoom photoshoot can be added to package. Your Story in Art Package C: Custom one-on-one art experience on Zoom with artist Shanna Israel using client's favorite themes and/or personal memorabilia + finalized art piece signed by Shanna + personal story/theme/art transformed into virtual art + up to 10 family shoutouts/photo montage + celebrity/influencer participation based on price/availability (shout out and/or interaction on Zoom with client). Additional people for Zoom photoshoot can be added to package.* Your Story in Art – Pkg A Your Story in Art – Pkg B Your Story in Art – Pkg C Other What is your projected budget? * $2,500 - $5,000 $5,000 - $10,000 $10,000+ Ideal Date(s) of Experience? * Please list three dates. Note: Delivery day must be 6 weeks or more from the date of signed contract agreement and receipt of 50% down payment. Favorite sports: * Favorite celebrities: * Favorite colors: * Hobbies: * Favorite movie characters: * Favorite music artist or genre: * Other preferences: * Did anyone refer you? If so, please enter their name. Thank you!