Prairie Chicken Photo Restoration Order Form

Print this form for photo restoration.Use a separate form for each photo that is to be restored.

Please Print
Today's Date___________________

Your Name__________________________________

Address__________________________________________________________

City or Town__________________________________

Postal Code/zip code_____________________

Area Code__________Phone Number_________________

Best time to call_________________

E-mail Address______________________________________

Print Number or Name of print:(Number back corner or Name each print) ___________________________________________________.

Check mark each service requested and explain in detail to the best of your ability. If you can describe it, most likely we can do it. Use back of form if necessary. ___Remove scratches and cracks, ___Lighten print, ___Darken print,_____Increase contrast, ___Decrease contrast,_____Remove person or object, ___Add person or object.(Explain in detail or provide sketch using stick figures.)

_____Add color or tone to Black & White print: Explain in detail or provide sketch.

_____Photo Cropping: Explain in detail or provide sketch of area to be removed.

Return Photo files on disk (PC format only) ___ 3 1/2 floppy ($2.00)

Size# of final prints: ___match original, ___5x7, ___8x10, ___custom size. Ask for quote

Additional :

  • 2 5x7's $12.95 ____x __________=__________

  • 1 8x10 $12.95 ____ x __________=__________

  • Check or money order enclosed _____ check here. (Manitoba Residents Add 7%pst.) Sign here to authorize order: ____________________________________Date____________

    Service Limitations

    Prairie Chicken Photo Restorations reserves the right to return restoration requests (with payment) without service if the requested service cannot be performed due to equipment limitations or copy-right problems.