-ORDER FORM-
(Special rate for Debbie Allen Dance Academy)

Important: Please be sure to print clearly and fill out each applicable blank.

A portion of the proceeds will be donated to the Debbie Allen Dance Academy




NAME:
EMAIL ADDRESS:
ADDRESS:
CITY/TOWN: STATE/PROV: POST/ZIPCODE:
COUNTRY:

-Items Ordered-

Package Unit ea. Quan.   Total Amt.
1 – 5 x 7
$8.00  
 
 
Specify Photo Number(s)      
  shipping and handling    
  ORDER TOTAL    
AMOUNT RECEIVED 

If you need assistance or special ordering procedures, please send an email to info@whitakerhistoricphotography.com
Mail completed order form with your payment to:

Delroi Whitaker
Whitaker Historic Photography
PO Box 88348
Los Angeles, CA 90009 USA


A portion of the proceeds will be donated to the Debbie Allen Dance Academy