Larry Webster Photography
103
West Washington Street
Remington,
Virginia 22734
540.439.7070
SPRING CONCERT
*******One Person Only*******
Package #1 1-5x7 $10.00 ___________
Package #2 1-5x7 4 Wallets $15.00 ___________
Package #3 1-5x7 1-3x5 4 Wallets $15.00 ___________
Package #4 1-8x10 $15.00 ___________
Package #5 8 Wallets $12.00 ___________
TOTAL ___________
Buddy
Special: EACH PERSON IN THE PHOTO MUST ORDER
1 – 5 X 7 1-3
x 5 2 wallets ($10.00 per person)
PACKAGE #6 2
PEOPLE $20.00 _____________
PACKAGE
#7 3 PEOPLE $30.00 _____________
PACKAGE
#8 4 PEOPLE $40.00 _____________
PACKAGE
#9 5 PEOPLE $50.00 _____________
PACKAGE
#10 6 PEOPLE $60.00 _____________
PACKAGE
#11 7 PEOPLE $70.00 _____________
Name
_____________________________________________ Grade __________
Parents’ Name
________________________________________ Email ___________________________
Address
_______________________________________________________________
City _____________________________________ State ________ Zip ____________
Phone Number ____________________________ Cell Phone _____________________
CREDIT CARD INFORMATION
Type of Credit Card: _______________
Expiration Date: ___________ Sec. Code __________
Credit Card Number:
____________________________________________________
Name
on Card: ________________________________________________________
Signature:
____________________________________________________________
You
may pay by cash, check, or credit card. Please pay on Picture Day.
