-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