Pay By Check Order Form

To pay by check:

  1. Print this form.
  2. Fill in all fields (prices are listed on photo page).
  3. Make check payable to Billy E. Barnes.
  4. Mail form and check to:

Billy E. Barnes, 313 Severin St., Chapel Hill, NC 27516

Name _____________________________________________________________________

Street Address (for UPS) ______________________________________________________

City ________________________________ State ____________ Zip __________________

Phone/Day __________________________ Phone/Eve _____________________________

Please send me the following:

 Number
of Prints		 Price
Each 		Total for
This Item


Name of Photo: _____________________________________________

Size: 8 1/2" x 11"     11" x 14"     16" x 20"     20" x 24"

 ______ ______ ______


Name of Photo: _____________________________________________

Size: 8 1/2" x 11"     11" x 14"     16" x 20"     20" x 24"

 ______ ______ ______


Name of Photo: _____________________________________________

Size: 8 1/2" x 11"     11" x 14"     16" x 20"     20" x 24"

 ______ ________ ______


Name of Photo: _____________________________________________

Size: 8 1/2" x 11"     11" x 14"     16" x 20"     20" x 24"

 ______ ________ ______


Name of Photo: _____________________________________________

Size: 8 1/2" x 11"     11" x 14"     16" x 20"     20" x 24"

 ______ ________ ______

TOTAL

 		______