LOADING...  Please wait.

Senior Portraits Order form
Queen City Photography
1525 Churchville Ave
Staunton VA 24401
 
Senior information
Important: Enter a valid e-mail address. Receipts will be sent to this address. (do not use Student email)
E-Mail:*

School*

Student ID

Student First Name*

Last Name:*

 
Individual prints and products are available only with purchase of package(s)
Packages
Enter Your Product Selections Below
Item DescriptionItem PriceQuantityTotal
Formal pose only 3-8x10 4-5x7 24-wallets
Select pose

Casual Package - 1-11x14 2-8x10 4-5x7 24-Wallets
E-mail pose selections or questions to Staff@qcpva.com
Premiere: 1-11x14 5-8x10 8-5x7 48-W + Digital Copies
E-mail pose selections or questions to Staff@qcpva.com
Package ordered.*
 

package validation
Individual prints and products are available only with purchase of package(s)
Prints
Two (2) - 4x6
(2)5x7
8x10
11x14
4 Wallets
8 Wallets
Products
Mouse Pad
Canvas Tote
Coffee Mug 11oz
Bag Tag
Magnet (3.5 x5)
Keychain: Silver - 1"
Dog Tag - Double sided
Key Tags - Set of 3
Grand Total:
 
Special Instructions:

Billing Information
Parent Name:*

Middle Initial:

Last Name:*

Address Line 1:*

Address Line 2:

City:*

State:*

Zip Code:*

Phone:*

Same as SHIPPING information?
Yes No 

Shipping Information
First Name:*

Middle Initial:

Last Name:*

Address Line 1:*

Address Line 2:

Phone:

City:*

State:*

Zip Code:*

Please Select PayPal check-out to pay with your credit card
Reset 
Powered by Elbowspace.com