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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*
Choose a School
Wilson Memorial High School
Ridgeview Christian School
Fort Defiance High School
R.E. Lee High School
Buffalo Gap High School
Waynesboro High School
Riverheads High School
Stuarts Draft High School
Stuart Hall School
Other
Student ID
Student First Name*
Last Name:*
Packages
Pose selection should be made from online gallery, NOT take home proofs.
Select Formal Pose
Choose a Select pose
Pose 1
Pose 2
Pose 3
Pose 4
Pose 5
E-mail picture sizes for below packages to staff@qcpva.com or list in Special Instructions below.
1 Sheet equals 1-8x10 or 2-5x7 or 3-4x6 or 8-wallets. An 11x14 equals 3 sheets.
Item Description
Item Price
Quantity
Total
SPRING SPECIAL: One Pose Digital Image
March 15 - May 1. Perfect for adding to your graduation announcements. Enter your pose selection (only 1) under Special Instructions.
Important - there are no digital or add-on options available with the $95.00 package.
Formal Session: Prints Only (1 Pose - 4 Sheets: Choose your sizes)
Formal Session: 8 Sheets (Choose your sizes) or Digital Images (Prints - 1 pose, Digital - up to 3 poses)
Digital Image and Print Add-On options will appear after choosing the $150 print package.
Add Digital Images to Your Print Package (up to 3 poses)
4 Sheet Add-On (1 Pose - may be different from package)
8 Sheet Add-On (Up to 2 poses - may be different from package)
Individual Prints - No Package Purchase Necessary
8x10
2-5x7
3-4x6
8-Wallets
Products
Bag Tag
Magnet (3.5 x5)
Keychain: Silver - 1"
Key Tags - Set of 3
Sub-Total:
Discount Code
Grand Total:
Special Instructions:
Billing Information
Parent Name:*
Middle Initial:
Last Name:
*
Address Line 1:*
Address Line 2:
City:*
State:
*
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District of Columbia
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New York
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Ohio
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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:*
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:*
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