D. C. Photographic Images

Order Form

Print the form, fill in your order and mail to:

D. C. Photographic Images
P.O. Box 8834
Norfolk, VA 23503-0834

Or call in your credit card order (8 a.m. - 8 p.m. eastern time) to: 757-583-1115

We accept checks, money orders or

All items shipped by USPS. Shipping to US addresses only

Please print clearly:

Name:___________________________________________

Address _________________________________________

City:______________________ State_____ Zip__________

Phone Number______________________ E-Mail Address___________________________ (optional)

Item Number & Description	Quantity	Price Each	Total
___________________________________	_________	_________	_________
___________________________________	_________	_________	_________
___________________________________	_________	_________	_________
___________________________________	_________	_________	_________
___________________________________	_________	_________	_________
___________________________________	_________	_________	_________
___________________________________	_________	_________	_________
___________________________________	_________	_________	_________
___________________________________	_________	_________	_________
Subtotal			_________
Less Discount Coupons (Include)			_________
Subtotal			_________
Shipping			____$4.40
VA Residents add 4.5% Sales Tax (or provide certification of resale and tax number)			_________
Total			_________

Please make checks or money orders in US Dollars payable to:      D. C. Photographic Images
Payment: ______ Check/Money Order        _____Visa        _____MasterCard
Card Number:__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __    Exp Date ____/____

Signature:_________________________________________________
Note: Credit Card Order will not be processed without the signature