Photo Reprints Form

Use the following online form to request a photograph. Once you have submitted the form, you will be contacted to complete the order, as we cannot accept your credit card online at this time. Photographs are $15 each, with a $1.50 shipping charge.

Name
Street Address
City
State
Zip Code
Phone Number w/ area code
E-mail Address
Publication Date
Photographer Name
Photo Description (please include the page number the photo ran on)

If you’d like us to mail the photos to you, please print this completed page and mail with payment to:

The Idaho Statesman
P.O. Box 40
Boise, ID 83707

(all mail must include a visible return address on the envelope or it will not be opened or returned)

PAYMENT METHOD(please check the box)

[ ] Check enclosed
[ ] Bill my credit card

Card type (MasterCard, Visa, etc)

__________________________________

Card #

__________________________________

Expiration Date

______ / _______

Name as it appears on the card

__________________________________

Signature (please sign to authorize)

__________________________________

Quantity ordered:

_______ reprints

x $15.00 / reprint

Subtotal: $ _____.00

+ $1.50 shipping fee

Total: .00

Photo Reprints Form

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