Picture Order Form

First Name

Last Name

Phone

School/Daycare

Child's Name

Please choose One pose (Image Number) for your package. Choose 2 for package D

Picture Package

Please select a Package

Package A + $15.00
Package B + $25.00
Package C + $35.00
Package D + $50.00
Package E All Digitals + $65.00

Package Image Number

ADD-ONs

A Package MUST be selected BEFORE any add-on can be purchased

Package ADD-ON

Pack A + $15.00
Pack B + $25.00
Pack C + $35.00
Pack D + $50.00

Package ADD-ON Image Number(s)

Digital ADD-ON Image #

Single Digital Image #

8x10 ADD-ON Image Number(s)

5x7 ADD-ON Image Number(s)

8-Wallets ADD-ON Image Number(s)

Class Picture Image Number(s)

Bag Tag Image #

COLLAGE Image Number(s)

Button Image #

White Mug Image #

5x7 Magnet Image # (choose 2-3 images)

Travel Mug Image #

Fun Pack Image #

Message

Photo Release (Please Sign and Date)

Telless Photography has my permission to use my or my child’s photograph publicly to promote their business. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Signature

To accept this contract, type your name below

Date

Billing Address

Address Line 1

Address Line 2

City

Country

Select

State/Province

Select

County

Select

Zip Code

Shipping Address

Same as Billing Address
Different From Billing Address

Address Line 1

Address Line 2

City

Country

Select

State/Province

Select

County

Select

Zip Code

Shipping Method

Standard Shipping $9.99

Sub Total

$0.00

Shipping

$9.99

TOTAL

$9.99

Payment Method

Credit Card

Credit Card Type

Select

Name on Card

Credit Card Number

Expiration Date

Month

Year

Verification Number

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Picture Order Form

Thank you for your purchase!