You may use this form to place an order for SCHOOL PICTURES using a credit card. A separate form must be used for each student for tracking purposes. Siblings cannot be entered on one form. If you prefer to pay with a check or cash, paper forms will be available at school during bear days.

Student Information

Select your school *

Student First Name (Registered name only, no nick names please!) *

Student Last Name (Registered name only!) *

Grade *

Parent/Guardian First Name *

Parent/Guardian Last Name *

Phone Number *

Email Address *

Street Address: *

Apt or Unit Number:

City: *

State: *

Zip Code: *

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

	Package A - 2-8x10s, 4-5x7s, 2-3x5s, 4-Wallets $49.00
	Package B - 1-8x10s, 4-5x7s, 2-3x5s, 4-Wallets $44.00
	Package C - 4-5x7s, 2-3x5s, 4-Wallets $37.00
	Package D - 2-5x7s, 2-3x5s, 4-Wallets $30.00
	Package E - 1-5x7s, 2-3x5s, 4-Wallets $24.00
	Package F - 2-3x5s, 4-Wallets $18.00
	Package P - Purchase the Digital Image of your individual picture (Image will be emailed to the email address you provide) $25.00
	Retouch (Enter Quanity of 1 for the Entire Purchase) $14.00

Please enter the quantity of each Add-On you would like to order.

	Add-on J - 1-8x10 $12.00
	Add-on K - 2-5x7s $12.00
	Add-on L - 4-3x5s $12.00
	Add-on M - 8-Wallets $12.00
	Add-on N - 2-4x5 Magnets $16.00
	Add-on Y - 8 Mini-Wallets $12.00
	Add-on U - ADD Digital Image to any Package above (Cannot be purchased by itself at this price, see above to purchase by itself) $15.00

Which picture do you want us to use to fill this order? *