Pro Image Dance Reorder Form

Dance Reorder Form

Please call or E-mail Pro Image prior to filling reorder form.
Proimagefoto@yahoo.com or 607-206-7426

Mail To:

Name __________________________________________________

Adress _________________________________________________

City ________________________ State ____ Zip _______________

All orders must be accompanied with a photocopy or original photo and number on back of print.
(Original will be returned)

Please use one order form per order.

(NY Tax included in price)

Photo was taken at:______________________________________

Student in photo:_________________________________________

1-8x10-----------------------------------------$15.12 ea. x_____= $_________

2-5x7------------------------------------------$15.12 ea. x_____= $_________

4-3.5x5---------------------------------------$15.12 ea. x_____= $_________

8-Wallets------------------------------------$15.12 ea. x_____= $_________

   1-3x5 Statuette----------------------------$11.88 ea. x_____= $_________

   1-8x10 Statuette (+$10 two people)----$37.80 ea. x_____= $_________

                                                                          S/H    $5.00

                                                                      Total $ _____________

Number from back of print if applicable

Frame Number:___________ or R____ F ____

There will be a $35.00 Bank Charge for insufficient funds.