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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:*
You will be prompted to choose a pose when quantity is entered. One pose per package.
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: 3-5x7 4-wallets $20.00
  
Pose:
   Fall - Yearbook
   Fall - Ruler
Package 1: 4-5x7 8-wallets $30.00
  
Pose:
   Fall - Yearbook
   Fall - Ruler
Package 2: 1-8x10, 4-5x7, 8-wallets $38.00
  
Pose:
   Fall - Yearbook
   Fall - Ruler
Package 3: 2-8x10, 4-5x7, 16-wallets $50.00
  
Pose:
   Fall - Yearbook
   Fall - Ruler
Premier : 1-11x14, 2-8x10, 4-5x7, 24-wallets $70.00
  
Pose:
   Fall - Yearbook
   Fall - Chalkboard
Package ordered.*
 
Individual prints and products are available only with purchase of package(s)
Pose:
   Fall - Yearbook (WMHS orders)
   Fall - Chalkboard
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 & Processing ($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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