Jeff Berner Print Order Form

Print Order
Request Quote Form

Have you seen a photo on this site that you'd like to have a print of or use in something for
your own? Order archival prints here directly. You can also purchase black-and-white or
toned reproductions of any image or please contact me for any other custom manipulations
you may have in mind. I also offer imagery for business cards, promo-cards, CD covers
and calendars. Inquire about any other ideas you my have...

© All photos on this site and sold by Jeff Berner Photography & Art are under copyright.
Photos may not be reproduced or used in any way without written consent from Jeff Berner
and/or related licensing agents. All photos are for noncommercial use only unless otherwise
stated in contract. For information on commercial use or publication, please call or email to
ask for republication rate information or fill in the intent field in the form below.

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Print Request Quote Form

To order a print, enter the following information which you may submit from
this form, copy and send by email (easiest), print and send by mail or deliver in person. You
may also contact me at 585.765.2638. Please have the information below ready. I will get a
quote back to you as soon as possible. Notify me if there is a need for an express order and
I will expedite your requests.

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Image Information - For ordering multiple prints of different images, copy and paste the
Image Information section of this form into an email or print out for the desired number of prints.
Copy and paste the billing information thereafter.

Image Title
Portfolio Area
Brief Description
© Intent for Image/ Copyright Info
Specific instructions or manipulations
Quantity
Size / format
Surface / paper

________________________________________________________________________________________ Billing / Mailing Information
First name
Last name
Day phone
Mailing address
Apartment #
City
State
ZIP Code
Country
Method of payment :	Check enclosed (print and mail form) Money Order (print and mail form) PayPal- Send funds to jeffdberner@myway.com ___ Bidpay- Send funds to jeffdberner@myway.com

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Comments or Questions:

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-Submits form through your default email program
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or copy above form and email to:
jbphoto@myway.com
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or print and mail request to:

Jeff Berner
Photography & Art
10209 Millers Rd.
Lyndonville, NY 14098