Name_____________________________________________

Adresss____________________________________________________________

City_____________________________             State______  Zip ___________

Email_____________________________________________________

Credit Card Number______________________________________________

Exp_____/____/_____   CCID # (Last 3 Digits on Back of Card)___________

Film Processing Order Form

Please circle

Film Type

Color

B & W

Slide

if you have slides would you like for them to be

Mounted

Kept Uncut

Prints

Yes

No

if yes

Glossy

Matte

Pro-Matte

Number of Sets

Single Set

Double Set

Other ________________

Prints on Cd

Yes

No

if Yes

Low

Medium

High

Would you like a white border on prints

Yes

No

Print Size

3.5x5

4x6

4x5

5x5

5x7

Panoramic

Would you like your order

Pick up in store

Mail order back to me

if we mail order back to you, you will be charged shipping and handling

Special Instructions

Please print and send in with order to:

Rochester Photographic Inc.

Attn: Mail Orders

160 Park Ave

Rochester, New York 14607