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Galleria Ventures Photo Business Card: Mail in Order Form

(update 07/20/06)

Please print this page using the "print" button on your browser. Fill it out as desired and mail it to:
Galleria Ventures, PO Box 20555, Sedona, AZ 86341 with a copy of the printed photo you want on your business card. ( negatives and slides are okay too )

Your Name: __________________________________________________________________

Your Email address: ____________________________________________________________

Please double check you email address. This is the way we will respond to your request.
After we receive this information we will confirm your order by sending you an e-mail with a link to a web page where we will have a digital proof image of your card for you to confirm approval.

Please make a sketch on how you would like us to layout your card - include text and photo

Options on placement of photo image on card:

[ ] Image fills card
[ ] Image on left side of card
[ ] Image on right side of card
[ ] Other, please explain: ________________________________________

Special Instructions:_________________________________________________________

________________________________________________________________________

________________________________________________________________________

You can send payment information now or when you confirm your business card layout as being approved.
Either way we will not process your payment until we have confirmed your layout approval.

Method of Payment: _____Check ____Visa _____ MasterCard _____AMEX _____Discover

Card Number:_________________________________________ Exp date:___________

Authorized signature of cardholder _______________________

Send to: Galleria Ventures, PO Box 20555, Sedona AZ 86341 Telephone:928-202-4458