PHOTO REPRINT ORDER FORM
Name: _________________________________________________________________________
Address: ________________________________________________________________________
City, State & Zip___________________________________________________________________
Daytime Telephone: _______________________________________________________________
Date photo was published:___________________________ Page number:___________________
Subject of photo:__________________________________________________________________
ORDER INFORMATION
Size: _____________ Quantity: ________ Cost each: _______________ Total cost: ______________
Size: _____________ Quantity: ________ Cost each: _______________ Total cost: ______________
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Total Due: ______________ Less 20% discount: ______________ Postage & Handling: __ _$5.00__ _ Total Enclosed: ______________ |