Repub.com: Photo Order Form

ORDER FORM FOR REPUBLICAN PHOTO REPRINTS

You may order a reprint of a photograph published after July 1, 1996, and taken by a Republican staff photographer. Color reprints of photographs are available in standard 8x10 format.

The cost for one photo for any nonprofit and/or personal use is $20. If you are ordering multiple reprints of the same photo, the first photo will be full price; additional photos will be $15.00. Massachusetts residents only - include 5% state tax. There is a $2.00 shipping charge per order.

To Order (please mail or fax):

Include a copy of the published photograph, if possible; the date of publication, caption, and name of the photographer.
Make checks payable to The Republican and mail to:

Photo Reprints
Attn: Cashier
PO Box 1930
Springfield, MA 01102-1930
Visa, Mastercard, Discover and American Express accepted.
Credit Card orders may be faxed to: (413) 788-1381.
Please allow two to four weeks for delivery.

Photo description:

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Date of publication:

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Photographer's name:

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Intended use of photo:

____________________________________________________

Payment to Republican:

____________________________________________________

Your name:

____________________________________________________

Your address:

____________________________________________________

Street

City

State

Zip

Day time phone:

____________________________________________________

Credit card:

Visa _____ MasterCard _____ Discover _____

Credit Card Number:

____________________________________________________

Expiration Date:

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Signature:

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	Please send ________ photos @ total price	$ __________
	5% Sales Tax (Mass. residents only)	$ __________
	Shipping	$ _____2.00_
	Total enclosed	$ __________