Dance Reorder Form 2011
Please call or E-mail Pro Image prior to filling reorder form.
Proimagefoto@yahoo.com (607) 206.7426

MAKE CHECK PAYABLE TO:
Thomas La Barbera
7309 Foxridge Circle T1
Anchorage, Alaska 99518

All orders must be accompanied with a photocopy and numbers from back of print.
Please use one order form per pose, add S/H once.

Dance Studio ____________________________________________________________

Student Name ___________________________________________________________

Phone __________________________________________________________________

Numbers from back of print _________________________________________________

1-Digital Memory Mate-----------------------------$15.12 ea. X ____= $_________

1-8x10-------------------------------------------------$15.12 ea. X ____= $_________

2-5x7---------------------------------------------------$15.12 ea. X ____= $_________

1-5x7---------------------------------------------------$10.80 ea. X ____= $_________

4-3x5---------------------------------------------------$15.12 ea. X ____= $_________

2-3x5---------------------------------------------------$10.80 ea. X ____= $_________

1-3x5---------------------------------------------------$5.40 ea. X ____= $_________

8-Wallets----------------------------------------------$15.12 ea. X ____= $_________

1-8x10 Statuette (Add $10 for 2 person)-------$37.80 ea. X ____= $_________

1-3x5 Statuette Magnet----------------------------$11.88 ea. X ____= $_________
                                                                                                    


Broome County sales tax included.....................................TOTAL $_________
$35.00 BANK CHARGE FOR INSUFFICIENT FUNDS

Thank you for your order, please allow 2-6 weeks for delivery.

Mail photographs to:

Please add S/H $5.00

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