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Fill out completely and mail with payment to: Ur Pics, PO Box 3181, Kearney, NE 68848

CUSTOMER INFORMATION
Name: Phone (day):
Address: Phone (evening):
City: State: Zip: E-mail:
Event: Date:

PHOTO SELECTION

Wallet Prints 
2 1/2" x 3 1/4"
$2.00 each

 4" x 6" Prints
@ $3.00 each		 5" x 7" Prints
@ $5.00 each		 8" x 10" Prints
@ $8.00 each		 Miniature Photo Key Chain
@ 3.00 each		 Poster  11" x  14"
@ $18.00 each		 Magnet  4" x 6"
@ $8.00 each

Photo #

 Qty

Photo #

 Qty Photo # Qty Photo # Qty Photo # Qty Photo # Qty Photo # Qty
                           
                           
                           
                           
                           
                           
                           
                           

Item

Quantity

Price Each

Total

PAYMENT INFORMATION
Wallet Prints $2.00

Make checks payable to :
 Ur Pics  LLC   

Mail  to: 
Ur Pics  LLC
PO Box 3181
Kearney NE  68848


If paying by check:  We must wait 7-10 business days until we have verification that your funds have cleared. Make sure your name, address, and phone number is on your check.

Order will be processed within 2 days if paid by credit card through Pay Pal.
E-mail address:  photos@urpics.com
  Sign up for PayPal and start accepting credit card payments instantly.

Pricing good through 12-31-05

4" x  6"

 $3.00

5" x  7"

$5.00
8" x  10"

$8.00
Miniature Photo Key Chain $3.00

Poster  11" x  14"

$18.00
Magnet  4" x  6" $8.00

We accept Continental U.S. orders only.

 Sales Tax:
Nebraska residents
please add applicable sales tax.		    $_______

Shipping & Handling

$5.00
TOTAL    $_______