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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). Orders will NOT be filled if package is not ordered.
Packages
Enter Your Product Selections Below
Item Descr
Quantity
Total
Digital Package: Individual Images emailed to you $35.00
  
No refunds will be issued after link is sent.
Package 1: 3-5x7 4-wallets $25.00
  
Pose:
   Fall - Yearbook
   Fall - Ruler
Package 1: 4-5x7 8-wallets $35.00
  
Pose:
   Fall - Yearbook
   Fall - Ruler
Package 2: 1-8x10, 4-5x7, 8-wallets $43.00
  
Pose:
   Fall - Yearbook
   Fall - Ruler
Package 3: 2-8x10, 4-5x7, 16-wallets $55.00
  
Pose:
   Fall - Yearbook
   Fall - Ruler
Premier : 1-11x14, 2-8x10, 4-5x7, 24-wallets $75.00
  
Pose:
   Fall - Yearbook
   Fall - Ruler
Class Photo $10.00
  
Class Photo size
   8x10
   2-5x7
Package ordered?*
 
Individual prints and products are available only with purchase of package(s)
Select pose for single items:
   Fall - Yearbook (WMHS orders)
   Fall - Ruler
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
  
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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