PRO IMAGE

​​Date of Photograph __________________

Number on the tab: _______ or Numbers from  back of print: ________________________________________________________

Student Name ____________________________________________ Dance Studio____________________________________________

​One Order Form Per Pose

                                                                                                                                Price                     Qty                          Total
                                                                                         
                                  8x10 Digital Memory Mate                                 $20.00

                                  1-8x10, 2-5x7, 4-3x5, 8-Wallets                       $60.00

                                  1-8x10                                                                             $20.00

                                  2-5x7                                                                                $20.00

                                  4-3x5                                                                                $20.00

                                  8-Wallets                                                                       $20.00

                                  2-3x5                                                                                $12.00

                                  1-8x10 Statuette Standing Cutout                  $40.00

                                  1-3x5 Statuette Magnet Cutout                       $14.00

                                  4-Wallets Die Cut Magnets                                 $18.00

                                  1-5x7 Class Group Only                                        $12.00

                                                    One check for multiple packages is preferred. Thank you!
                                                                                                                              Total $__________________
                                                                                                         Prices include sales tax & shipping.

                           Mailing To: ______________________________________________________________

                                                     ______________________________________________________________

                                                     ______________________________________________________________

                           Phone: (_____)____________________________________________________________

                                                              $35.00 BANK CHARGE FOR INSUFFICIENT FUNDS
 
Make check payable to:
PRO IMAGE
839 Oak Hill Ave
Endicott, NY 13760
607-206- 7426
www.thomaslabarbera.com

© 2017 Thomas La Barbera Photography