CHRIS STACKHOUSE PHOTOGRAPHY: ORDER FORM

Phone with your credit card number for immediate ordering, or print out and mail this form.

PURCHASER INFORMATION Name Address Address 2 City Province/State Postal/Zip Telephone Email		RECIPIENT INFORMATION (if other) Name Address Address 2 City Province/State Postal/Zip Telephone Email

Quantity	Size	Title	Photo ID#	Price	Total

Total amount due:                      

SPECIAL INSTRUCTIONS

BILLING INFORMATION

Name as it appears on card
Credit card number
Expiry date

This is not a secure online order form. If payment is to be made by MC/Visa, print this form mail to the above address.