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Name: ______________________________________________( Please Print )

Address: ____________________________________________

City, State, Zip: _______________________________________

Phone: ( ____ ) ____-______ Fax: ( ___ ) ____-______

Email address: ________________________________

Please check one: MAC TIFF FORMAT ____ or WINDOWS JPEG FORMAT ______

PRICE BREAK ON 19 OR MORE.

Quantity
______ Negatives, Transparency, Slides & Photos up to 4" x 6" , First 19 @ $1.25 = ..................... $
______ Negatives, Transparency, Slides & Photos up to 4" x 6 " , 20 & above @ $1.00 = ............... $
______ Negatives, Transparency, Slides & Photos up to 8" x 10" , First 19 @ $2.50 = ................... $
______ Negatives, Transparency, Slides & Photos up to 8" x 10" , 20 & above @ $2.25 = ............. $
CD Disk $    10.00
  *   Shipping & Handling $    15.00
TOTAL $

* ( Federal Express 2nd day within So. FL., all other areas call for rates or include a prepaid envelope or  box )

All work is returned. Price subject to change without notice.

Make Check or Money Order payable to MannyGeller.Com, Inc.

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MannyGeller.Com, Inc.
920 N.E. 199th Street - 311
Miami, FL  33179 USA
(305) 332-9052