Photo Order Sheet (please print clearly) or e-mail your order to PhotosByLois@hotmail.com

Name:                                                                  
Street Address:
 
City:
State: Zip Code:
Gallery Name: Family Name or Bride & Groom  Method of payment:  mark one

 
 cash____    credit card _____ (call with information)

PayPal ______

 check #_____payable to:  Artistic PA Photography
Photo Name/number  Quantity    Size Description & special instructions       Price
         
         
         
         
         
         
         
         
         
         
         
         
                                                                                                                                          Shipping   $     6 .00
         Total Payment enclosed   $      .

Evening Telephone Number: (______)   _________-__________

For Credit Card Orders: mailing address must match billing address on your card

We may request verification of security code from the back of card via telephone

Print Name as it appears on credit card: ________________________________________________

Evening Telephone Number: (______)   _________-__________

 

       mark an X through type of card

Call with - Card Number: ________-________-_______-________       Expiration Date: _____/_____ (mm/yy)

We will  request verification of security code from the back of card via telephone