Order Form

Film Strip of Abstract Art

Film Strip of Flowers and Flags

Thank you for placing your order with Photographic Reflection.

In the form below please provide your name, address, telephone number or email address and the title or file number of the images you desire. Also, please fill in the Comments or Request for Additional Information box below to provide additional information or special requests regarding your order.
Items marked * indicate required information.

* First Name:
* Last Name:
Company:

Address:

City:

State:
Zip Code:

* Telephone Number:
* Email Address:

IMAGE ORDER
Image Title or File Number:

Image #1:
Image #2:
Image #3:
Image #4:
Image #5:

Comments or Request Additional Information

Sample Pricing
Stock, Web Image, jpg 24K, 1-Year Use	$85.00
Stock, Digital, 1/4 Page, Local, Corporate	$185.00
Stock, Advertising Brochure, 1-Year	$500.00
Stock, Internal Calendar Page, 1-Year	$550.00
Stock, Main Calendar Cover, 1-Year	$800.00
11"x14" Archival Digital Print Size, Matted	$180.00
11"x14" Archival Digital Print Size, Framed	$235.00
16"x20" Illfochrome Print Size, Matted	$255.00
Prices subject to change without notice

Services Include:

Fine Art
Stock

Historic

Wetland

Nature

Wildlife

Baltimore

Annapolis

Washington, D.C.

Chesapeake Bay

Available For
Freelance
Assignments

For additional information, consultation, or pricing, please call, fill out the information request (left), or email us.

Updated: 09-April-2004

Michael A Dulisse Photographic Reflection

Order Form

Michael A Dulisse
Photographic Reflection