Order Form

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Name _________________________  Address ____________________________________

City ___________________________ State _______________   Zip

Home Phone ____________________ Work Phone ________________ Contact at work/home

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Image Title

Photo size

Matt size

Do you want Framing

Price

Example “Iwo Jima at Night”

7x10

12x16

Yes

$100

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Subtotal                                                                                             _______

Shipping:  add 15% for shipping

 

Subtotal (with shipping)                                                                       _______

Sales Tax (Virginia Residents Only) – add 5%                                        ______

Total                                                                                                 _______

 

***Have questions, specials needs or requests? Call or e-mail us (contact info below)***

Payment Info

___ Money Order *    ___ Check *     ___ MC     ___ Visa      ___ AMEX

Credit Card Number ___________________________ Expiration Date ___/___

Name (exactly as it appears on Credit Card) _____________________________

Signature (required for credit cards) __________________________________

 

·                Please make checks or money orders payable to Paul and Partners, Inc.

·                 

Lovelypicture.com * 43670 Trade Center Place * Suite 150

Dulles, Virginia 20166

Phone: 703-996-0800  Fax: 703-996-0888

 

E-Mail: joebaca@lovelypicture.com