REORDER FORM
Please type in the following information then PRINT this form.
If you are
missing photos
, click
Adjustment Form
.
Pricing is for Underclass School Portraits only. For candids, sports or
seniors portrait product pricing please contact our office.
Mail to:
Barksdale School Portraits
Attn.: Reorder Dept.
380 Turner Way
Aston, PA 19014
Student Information:
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First Name:
Last Name:
School Name:
Teacher's Name
School Address:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Grade:
Shipping Information:
First Name:
Last Name:
Address:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Phone:
Reorder Information:
Printer ID #
Your Image ID number is located on the revise side of your print.
Sample:
5039_20 IMG_8560
Set(s)
2 - 3½
x 5
Magnets
$15.00
Set(s)
11 x 14
$30.00
Set(s)
1 - 10 x 13
$25.00
Set(s)
1 - 8 x 10
$15.00
Set(s)
2 - 5 x 7
$15.00
Set(s)
4 - 3 ½ x 5
$15.00
Set(s)
8 - 2½ x 3½
(large wallet)
$15.00
Set(s)
16 - 1¾ x 2½
(small wallet)
$15.00
Set(s)
2 Keychains (1
¾
x 2
½
)
$15.00
Postage/Handling for this order
$
Payment Method:
Select
Check
Visa
MasterCard
Discover
American Express
Total
$
Card Number:
Expiration:
CV2 Code:
Signature:
___________________________
Name as it appears on card:
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