K&G Video/Photo Order Form

PHOTO EVENT/DATE:
  PRICE PER PACKAGE QTY TOTAL
LCHS Senior Sports Photo

$19.95ea

REPRINTS WITH MAT      
1 - 5"x7" Team Photo

$10.00

1 - 5"x7" Individual Photo

$10.00

       
4 - Wallet Size

$4.00

1 - 8"x10"

$15.00

 

 

   

BABE RUTH  COMMEMORATIVE PHOTO  

 

 
1 - 16" x 20" (only)

$50.00 + $10.00 s/h

Cash Check   Money Order

 
    TOTAL AMOUNT ENCLOSED

NOTE:  Payment by check is preferred, but if paying by cash, exact change is required.
Please make checks payable to: 

Gus Glikas

Phone:    (703) 777-4717
E-mail: kgvideophoto@ix.netcom.com
Website: www.gusglikas.com
Address 308 Appletree Dr. NE Leesburg, Va 20176

YOUR CONTACT INFORMATION
NAME:
ADDRESS:
CITY:
STATE:
ZIP:
PHONE:

PLEASE PROVIDE COMPLETE INFORMATION ABOUT YOUR TEAM
TEAM NAME:
TEAM COLORS:
JERSEY NUMBER:
PICTURE NO:
After completing this form, please double check it for accuracy, print it and mail with payment.  Orders will take approximately two to three weeks to process and will be mailed to you at the address provided above.  Thank you.