Fraternal Composite Service

1 Please Do Not Tear Return Entire Form Please Do Not Tear Return Entire Form Please Do Not Tear Return Entire Form - Please Do Not Tear - Return Entire Form Please Do Not Tear Return Entire Form Please Do Not Tear Return Entire Form Please Do Not Tear Return Entire Form - Please Do Not Tear - Return Entire Form Please Do Not Tear Return Entire Form Please Do Not Tear Return Entire Form Please Do Not Tear Return Entire Form - Please Do Not Tear - Return Entire Form Please Do Not Tear Return Entire Form Please Do Not Tear Return Entire Form Please Do Not Tear Return Entire Form - Please Do Not Tear - Return Entire Form Bronze Package $ Two 5x7 Portraits 16 Wallet Size Photos Silver Package $ Two 8x10 portrait 16 Wallet Size Photos Gold Package $ Six 5x7 Portraits 16 Wallet Size Photos Platinum Package $ Three 8x10 Portraits 16 Wallet Size Photos Unbelievable Package $ Two 8x10 portrait Two 5x7 Portraits 24 Wallet Size Photos Astonishing Package $ One 10x13 portrait Three 8x10 Portraits 24 Wallet Size Photos Payment Options 1) Make Check or Money Order Payable to Fraternal Composite Service or Fill In Your Credit Card Information and Use the Envelope Provided To Return This Entire Form by mail.

2 2) Fill In Your Credit Information and Return This Entire Form by fax to (315) 733-1971. 3) For EXPRESS Service , CALL 800-448-9305 to Place Your Order by Phone and Inquire About Special Promotional Offers! Fraternal Composite Service Professional portrait Studio 169 Campbell Avenue Utica, NY 13502 EXTRA With Package Without Package PRINTS Purchase Purchase Four 3x5 $ $ Two 5x7 $ $ One 8x10 $ $ 16 Wallets $ $ 24 Wallets $ $ One 10x13 $ $ PROFESSIONAL portrait ORDER TOTAL Qty Package or Print Pose No. Price Total ___ _____ _____ ____ _____ ___ _____ _____ ____ _____ ___ _____ _____ ____ _____ 2nd Pose Retouch (1st Pose Retouch is Included) $ ___ __ S&H $ Subtotal _____ NY State Residents ONLY Sales Tax _____ Professional portrait Order Grand Total _____ School Organization Gallery Pose Number Person Photographed _____ _____ _____ Credit Card Number 3 or 4 Digit Code Exp.

3 Date SIGNATURE_____ DATE_____ PLEASE SHIP THIS ORDER TO Daytime Telephone Number ( ) - Email Address: Verify Telephone Number ( ) - Please Allow 4 6 Weeks for Shipping Greetings! We recently had the pleasure of photographing your loved one for their organization s Composite and are pleased to present our professional portrait packages for your consideration. Please review the enclosed proofs to select the pose number of the photograph or photographs you wish to use to create your professional portrait package.