| Heavenly Images - Order Form - Part 1 | |||||||||
| Name | |||||||||
| Street | |||||||||
| City | State | ||||||||
| Zip | Phone | ||||||||
| To order pictures - **Answer the following questions & **Complete price list on back | |||||||||
| 1. Pick your favorite sample from the sample sheet enclosed | |||||||||
| Sample # | Title | ||||||||
| 2. Do you want to add the name and/or dates? (optional) (NO CHARGE) | |||||||||
| Name | |||||||||
| Dates | |||||||||
| 3. Do you want to include a poem or verse on the picture? (optional) ($3 CHARGE) | |||||||||
| 4. Do you have any special instructions? (optional) | |||||||||