Complete this form to reserve your copy of The Green Fairy’s Canvas. You’ll be redirected to secure payment on the next step. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Customer DetailsName *FirstLastEmail *Phone Number * Tier Address Shipping Shipping Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeOrdersPre-order Tier *--- Select Choice ---Standard ($45)Supporter ($75)Patron ($150)Confirmation *I understand this is a pre-order and that delivery will occur at publicationI acknowledge that pre-order purchases are finalSubmit