ABI fax/mail form

Mail to: A Beautiful Image 7970 Archer Ave. Fair Oaks, CA 95628 All prices include shipping and handling

Your Name:	_________________________________________________________
Your Email	_________________________________________________________
Street Address:	_________________________________________________________
City:	_________________________________________________________
State:	_________________________________________________________
Zip:	_________________________________________________________
Phone Number:	_________________________________________________________


Quantity	Image Name	Image Size (circle one)		Total
____	_____________________	10x14 Image Only $45 11x16 Image Only $55 12x18 Image Only $65		____________

____	_____________________	10x14 Image Only $45 11x16 Image Only $55 12x18 Image Only $65		____________

____	_____________________	10x14 Image Only $45 11x16 Image Only $55 12x18 Image Only $65		____________

____	_____________________	10x14 Image Only $45 11x16 Image Only $55 12x18 Image Only $65		____________
			Subtotal	____________
			Grand Total	____________
Make Checks Payable to A Beautiful Image 7970 Archer Ave, Fair Oaks, CA 95628