ORDER FORM
Please fill out this order form and send it along with your
photos and portrait fee.
If you cannot print this page, please write the information on a sheet of paper.
This information is important so that I can contact you and send you your finished portrait.
All of this information is kept private and none of this information will be shared
or sold to others.
See privacy policy under the "General Information" link above for more information.

Your Name:

Your E-mail:

Street:

City:

State / Province:
/
Zip Code:

Please mark the corresponding box.
Remember: adding a 2" - 2.5" matte will bring your finished size up to
11" x 14" or 16" x 20" if you choose an unframed & unmatted portrait.

Package A: 11" x 14"
Framed & Matted $300.00.......... Unframed & Unmatted $250.00

Package B: 16" x 20"
Framed & Matted $350.00.......... Unframed & Unmatted $300.00

Package C: Custom
As prearranged by e-mail or phone.
How did you find out about this web site?
E-mail: lasalledesign@gmail.com
Address: P.O. Box 676 – Elburn, IL 60119