MAIL IN ORDER FORM – EMAIL ORDER
FORM
(print this page or cut and paste
into an email to order)
SINGLE IMAGES @ $14.99 for 8 x 10
#______ #_______ #______ #_______ #______ #_______
#______ #_______
#______ #_______ #______ #_______ #______ #_______
#______ #_______
#______ #_______ #______ #_______ #______ #_______
#______ #_______
TOTAL A = _________
SINGLE IMAGES @ $39.95 for 12 x 18
#______ #_______ #______ #_______ #______ #_______
#______ #_______
#______ #_______ #______ #_______ #______ #_______
#______ #_______
#______ #_______ #______ #_______ #______ #_______
#______ #_______
TOTAL B = _________
NEW! 4x6 SINGLE IMAGES @ $4.95 each
#______ #_______ #______ #_______ #______ #_______ #______ #_______
#______ #_______ #______ #_______ #______ #_______ #______ #_______
#______ #_______ #______ #_______ #______ #_______ #______ #_______
TOTAL C = ________ -OR- 20 for $89.95 x _____ = _____
SHIPPING (free if over $150.00) A + B + C = $5.00
Insurance (mandatory) $1.30 ($0.00-$50.00) (Add $1.00
for each additional $50.00) = _________
Grand total = _________
PAYMENT BY MAIL ________ (checks, MO)
NAME
____________________________________________________ DATE _________
STREET
ADDRESS_________________________________________________________
CITY ________________________________________ STATE
_______ ZIP ____________
PHONE # _________________E-MAIL ADDRESS
_________________________________
Remit Payment to
Geoff Stunkard
1682 Powder Branch Rd
Johnson City, TN 37601-6220
423-542-0159
qmpsales@quartermilestones.com
www.quartermilestones.com |