Print out this form and mail to:  

Cost (please see Photo Restoration and Requirements for details)

• $5.00 (US) - Resizing and Cropping only
• $5.00 (US) - each additional copy
• $15.00 (US) - Simple Changes
• $30.00 (US) - Moderate Changes
• $50.00 (US) - Major Changes

Please send full payment with your order.  Make check or money order payable to :  Peggy Cook

Name:

Address:

City:                                                        State:                                             Zip:

Phone Number: (in case I have a question about your order)

Email: 

If needed what is your preferred method of contact?  Phone   or   Email

Photo Specifications:

Resizing: Y  N  Indicate what size:

Cropped:  Y  N  (If necessary, photocopy photo and crop to your specifications)

Convert to Black and White:  Y  N

Toning Photo:  Y  N  What color?

Re-colored:  Y  N   How many colors?  Please be specific on what you would like colored and what color:

Removing and objects or background:  Y  N  (If necessary, photocopy photo and mark to your specifications)

What color or new background would you like?

Adding Items into photo:  Y  N  (make sure to include the items which need to be added into photo)

Include any additional notes here:

Payment:

Please enclose full payment with order.  Make check or money order payable to Peggy Cook