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.