CYBER  SCANS
ORDER FORM
Print this form, fill it in and mail it with your pictures.
I certify that I am 18 years old (or have my parents permission ) and authorize  CYBER  SCANS  to  post my picture scans on the internet  or send them via email  to my email address at:
(print clearly) _____________________________________________

First scan and post is free!   Free scan?  Yes___No___
ADDITIONAL SCANS:  THIS IS OUR PRICING:
Number of pictures to scan _______ US $1.00 each (If e-mailed US$2.00 each)
Number of Documents to scan  _______ US $2.00 each (If e-mailed US$3.00 each)
Total = $_______________
 
NOTE! If images are returned via e-mial, we charge US$1.00 per photo/document.

METHOD OF RETURNING SCANS AND PHOTOS:
Are we returning your pictures? ADD Postage = US $3.00 (or send a SASE) ______________ (un-returned photos will destroyed)

If you want the scans returned on a floppy disc (Gifs and Jpg's - about 10 pictures per disk.) please include US $2.00 per disc required______________yes/no and US $ 5.00 __________ for postage.  total amount inclosed: US $___________________
Payment method CASH, CHECK, or MONEY ORDER (personal checks US$5.00 minimum order)
print return address: ________________________________________________________

               ________________________________________________________
               ________________________________________________________
All pictures in the following format: (jpg, gif) please specify________________
Return pictures - remember to enclose postage and return address (Yes or No)? __________
Any special instructions or requests?
_____________________________________________________________________________________
_____________________________________________________________________________________
 
SIGN: ________________________________________DATE:__________________________________
 
ALL RIGHT RESERVED  CYBER  SCANS   1997 1998 1999
 (CYBER SCANS RESERVES THE RIGHT TO CANCEL THIS FREE OFFER AT ANY TIME)
 
 
 
 
 
 

(Hint - cut this address and tape it on your envelope as a label)

 
CYBER  SCANS
P.O. BOX 291044
SAN ANTONIO, TEXAS 78229
U.S.A.
 
 
 
 
 
 
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