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Student Portrait Order
Queen City Photography
1525 Churchville Ave
Staunton VA 24401
Customer E-Mail
Important: Enter a valid e-mail address. Receipts will be sent to this address.
E-Mail:*
School*
Student ID
Student First Name*
M.I.
Last Name:*
Teacher Name:*
Individual prints and products are available only with purchase of package(s)
Packages
Enter Your Product Selections Below
Item Descr
Quantity
Total
Digital Package: Individual Images emailed to you $35.00
  
Package 1: 4-5x7 8-wallets $30.00
  
Pose:
   Spring - Flag
   Spring - Woodland
   Fall - Yearbook (WMHS orders)
   Fall - Chalkboard
Package 2: 1-8x10, 4-5x7, 8-wallets $38.00
  
Pose:
   Spring - Flag
   Spring - Woodland
   Fall - Yearbook (WMHS orders)
   Fall - Chalkboard
Package 3: 2-8x10, 4-5x7, 16-wallets $50.00
  
Pose:
   Spring - Flag
   Spring - Woodland
   Fall - Yearbook (WMHS orders)
   Fall - Chalkboard
Premier : 1-11x14, 2-8x10, 4-5x7, 24-wallets $70.00
  
Pose:
   Spring - Flag
   Spring - Woodland
   Fall - Yearbook (WMHS orders)
   Fall - Chalkboard
Individual prints and products are available only with purchase of package(s)
Pose:
   Spring - Flag
   Spring - Woodland
   Fall - Yearbook (WMHS orders)
   Fall - Chalkboard
Package ordered.*
 
Prints
Two (2) - 4x6 $12.00
  
(2)5x7 $15.00
  
8x10 $15.00
  
11x14 $45.00
  
4 Wallets $10.00
  
8 Wallets $15.00
  
Products
Mouse Pad $12.00
  
Canvas Tote $20.00
  
Coffee Mug 11oz $15.00
  
Bag Tag $8.00
  
Magnet (3.5 x5) $7.00
  
Keychain: Silver - 1" $12.00
  
Dog Tag $12.00
  
Key Tags $8.00
  
Shipping ($5.00):
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:*
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