Mail Order Form

Select Your State Photograph ALABAMA ARIZONA ARKANSAS CALIFORNIA CONNECTICUT DELEWARE FLORIDA GEORGIA IOWA IDAHO ILLINOIS INDIANA KANSAS LOUISIANA MASSACHUSETTS MICHIGAN MISSISSIPPI NEW HAMPSHIRE NEW MEXICO NEVADA NEW YORK OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VIRGINIA WASHINGTON WISCONSIN

You may mail in your Check or Credit Card information

Select Check or Credit Card Pay by Check Pay by Credit Card

Please DELIVER my photograph to the following address:

Name

Address

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TO PAY PAY CHECK: Please make your check payable to BILL ADLER

TO PAY BY CREDIT CARD: Visa Mastercard American Express Discover

Name on Card

Credit Card Number

Expiration Month Year

Three Digit Security Code (Visa/MC/Discover) Four Digit Security Code (AMEX only)

Your Telephone Number Your Email Address

Please send me copies of the photograph at $49.95 each (includes shipping/handling) = $

Please print this form and mail to:

Bill Adler - PO Box 2846 - Alpharetta, GA 30023

This exclusive offer is brought to you by Bill Adler Photography. For over two decades we have spcialized
in political convention coverage. Visit our website: www.billadler.com
Customer Support and Questions: 800 756-1181