Order Form
Name _____________________________________________
Phone Number ______________________________
Address ___________________________________________
E-mail Address ______________________________
City ______________________________________________
State / Province ________ Postal Code ___________
Country (if other than US) _____________________________
Order Date _________________________________

Catalog #

Size

Item Description

# of Items

Price

Subtotal

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 Added Charges From First Page Here

Amount

$

Conservation materials (if applicable)

$

Shipping:
Mounted only prints-¬Ý 1-5 items add $6.00; 6-10 items add $12.00
Mounted, matted & framed- 1-3 items add $15.00
Free shipping on purchases over $350.00

Shipping Charges

$

Pa. Residents add¬Ý 6% Sales Tax

Total Amount Due

$

Office Use Only
Date Received _____________________________________

Allow 4-8 weeks for delivery
Send Check or Money Order (no Credit Cards please) payable to C.D. Denmon to:

Date Shipped _____________________________________

C.D. Denmon
1706 State Route 118
Sweet Valley, Pa. 18656
cddeers72@peoplepc.com¬Ý www.denmonphotography.com