Event Viewer Photo Order Form
			
	Kelly and Massa Photography		Phone#: 610 521-5252
	416-D Governor Printz Blvd.		Email: kellyandmassa@rcn.com
	Lester, Pa 19029			Website: www.kellyandmassa.com

Instructions:
1. Print out this form and then complete it.
2. Mail this form, along with your check or money order to Kelly and Massa.
*Only checks or money orders will be accepted for payment of this order.
*Make check or money order payable to: Kelly and Massa Photography
*Allow 3 to 4 weeks for delivery.

Please clearly print the information requested below.

Name: _________________________________   Phone#: ____________________________

Mailing Address: _____________________________________________________________

		 _____________________________________________________________


Event Name (IMPORTANT!)
as Listed on the Web Site: 	______________________________________________
	(Example: 2007 05.01 LaSalle Graduation 123)

Photo Selections: (If more space is needed, print and attach another form).

Available sizes: 4x6...$8.50    5x7...$10.50    8x10..$12.50


Photo Number	Size of Print	Quantity
(DSC_####)	4x6/5x7/8x10					
	
____________	_____________	________

____________	_____________	________

____________	_____________	________

____________	_____________	________

____________	_____________	________

____________	_____________	________

____________	_____________	________

____________	_____________	________


Total 4x6 @ $8.50 each	=	$___________

Total 5x7 @ $10.50 each	=	$___________

Total 8x10 @$12.50 each	=	$___________

Add Postage and Handling		      $ 3.00

Total Amount Enclosed		$___________ (Check or Money Order only)