UNIQPIX ORDER FORM |
PRODUCT: ____ PROUD
AMERICAN ____IN MEMORY ____ TOGETHERNESS PREFERENCES: ____ HEAD SHOT ____ FULL BODY ____ TEXT ____ NO TEXT TEXT:_____________________________________COLOR_________ CHECK IF PHOTO E-MAILED:____ PICTURE SIZE QTY COST ADDITIONAL COPIES 8' X 10' _____ $ 20.00 $ 10.00 5' X 7' _____ $ 15.00 $ 8.00 4' X 6' _____ $ 10.00 $ 5.00 WALLETS _____ $ 2.00 20 FOR $ 30.00 _________________________________________________________ SUB TOTAL $________ PA SALES TAX 6% $________ SHIPPING/HANDLING $________ TOTAL $________ NAME:___________________________________________________ ADDRESS:________________________________________________ PHONE #: ________(IN CASE WE HAVE QUESTIONS WITH YOUR PHOTO)NOT REQ. E-MAIL: _________(IN CASE WE HAVE QUESTIONS WITH YOUR PHOTO)NOT REQ |
PLEASE SEND CHECK OR MONEY ORDER PAYABLE
TO JOHN L SCHROLL III TO UNIQPIX 219A BIG OAK RD. DILLSBURG, PA 17019 PLEASE ALLOW 2-4 WEEKS FOR DELIVERY |