Sedona Digital Print Service ( Galleria Ventures)
 Scanning Order Form

(update 05/26/06)

Please print this page using the "print" button on your browser.
  Fill it out completely and mail or fax to Sedona.

Name____________________________ Phone Number___________________

Address_________________________________________________________

City___________________ State_______________ Zip Code______________

Email________________________________

Scan Order- Complete the following order form, and insert your slides, negatives, or prints into a mailer.

Product	Quantity	Price	Extended Price
35mm film or photo print  scan		$0.99
For 10 or more scans -		$0.75
Other format Image scans         ( 120, 220, 4x5 ) ( scan dpi or file size target can be specified, extra charge of $1/10 Mbyte for files larger than 60 MB TIF )		$4.99
For 10 or more scans -		$3.99
For recording files to CD:      - CD  ( 650 MB ) Internet transmission		$4.50 FREE
SALES TAX	in Arizona only	6.3%
RETURN SHIPPING       -  USPS Priority Mail		$4.95
TOTAL    (give total of extended pricing )			$

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Special Instructions:_________________________________________________________

Method of Payment:  _____Check  ____Visa  _____ MasterCard   _____American Express ______ Discover      or let us know if you prefer to pay us through your PAYPAL Account.

Card Number:_________________________________________ Exp date:___________

Send to: Sedona Digital Print Service , PO Box 20555, Sedona AZ   86341 Telephone:928-202-4458
  FAX: 702-973-2425  ,  email:   custserv2@galleriaventures.com

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