You may use this form to place an order for Father/Daughter Dance photos using a credit card. Price includes tax. Shipping is separate and is required for Home School and out of District students. Please submit 1 form per family, limited to one complimentary image per family.

Name of School *

Student First Name *

Student Last Name *

Grade *

Teacher Name (type NA if not applicable) *

Parent First Name *

Parent Last Name *

Phone Number *

Email Address *

Mailing Address *

Packages

Please enter the quantity of each package you would like to order:

	Package A - Complimentary 5x7 Photo No Charge!
	Package B - 2-5x7s, 2-3x5s, 4-Wallets $20.00
	Package C - 1-8x10, 2-5x7s, 8-Wallets $30.00
	Package D - Digital Download $25.00
	Package E - 1-5x7 $10.00
	Package F - 2-3x5s $10.00
	Package G - 4 Wallets $10.00
	Package H - 8 Mini Wallets $10.00
	Package I - 1-4x5 Magnet $10.00
	Package J - 1-8x10 $15.00
	Package K - 2-5x7s $15.00
	Package L - 4-3x5s $15.00
	Package M - 8 Wallets $15.00
	Package N - 2-4x5 Magnets $15.00

Shipping

Shipping is Optional, if you do not chose this option, your package will be sent to your student's school.
Shipping is Required for Home School students and Out of District students.

Shipping $6.00

Credit Card Information

Credit Card Type *

Card Number *

Exp Date (MM/YY): *

CVV *

Billing/Shipping Address *

Address Line 2

City *

State *

Zip Code *

Comment or Question?