| Total Cost of Pictures | $________________________ |
| Add $10.00 for Shipping and Handling | $10.00 |
| Colorado residents add 3% Sales Tax | $________________________ |
| Total Amount Due | $________________________ |
| Personal Check | ______ |
| Money Order | ______ |
| VISA | ______ |
| MASTERCHARGE | ______ |
| Your 16 digit number | ________ | ________ | ________ | ________ |
| Your 4 digit expiration date | ____ | ____ |
| Name | ________________________________________ |
| Address | ________________________________________ |
| Address | ________________________________________ |
| Address | ________________________________________ |
| Zip | ____________________ |
| Phone | ____________________ |
| ________________________________________ |