(This is where the Gallery Name appears on web site)

___________________________________________
Name

Order #Hit Counter

___________________________________________
Address

___________________________________________
City, ST., Zip

(______) ___________________________________
Phone

___________________________________________
Email		  
Gallery Name      File# Qty.  Product Name Price
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
________________________  _____________
photo_____ out of ______		 ______    __________   _______
Notes:        
    Sub-Total     __________

Please make check or money order payable to:        
Kenny Sturm Photography                               
8771 Old Waterford Rd.
Erie, PA 16509             		Shipping & Handling              $.50
PA residents 6% tax     __________
TOTAL ENCLOSED   $__________
All photos are 100% satisfaction guaranteed.