Jacquelines#11 5X7 4 Wallets $15.00

File#_____________ Name________________________________________ BDE_____________BN___________CO___________

Add on (2) 5X7 to any package for $15.00#21 8X10 1 5X7 4 Wallets $30.00

Address______________________________________ Town ____________________ST____ Zip__________ Phone#_______________________________________

Group shots (2) 5x7 $20.00

Package#_______________________$_____________ Add on _________________________$____________ Mail YES or NO $ 5.00

#31 8X10 2 5X7

CC #______________________________________________________ Exp date___________________ CVC__________________If billing address is different from above check here and place address on back of sheet.

Please make checks payable to: Jackie Madera(There is a $30.00 returned check fee)

8 Wallets $40.00

Cash or Check#_____________ Total $_______________

You can pay by cash, check or credit card.