. Name ____________________________________________________________________ . ~ Company ____________________________________________________________________ . Street Address ____________________________________________________________________ . City, State, Zip _______________________________________________________________ (USA) . Phone ______________________________________, ~ Fax _________________________________ . E-mail ____________________________________________ for order shipment notification
. Set-up fee (per order, includes first disc set) $ ____20.00____ . JPEG Option # ______: number of Singles ______ x $__________ per Left or Right window scan = $ ______________ . JPEG Option # ______: number of Pairs ______ x $__________ per L and R windows scans = $ ______________
. ~ Include TIFF-RGB format (25% of the JPEG scan price above) $ ______________ . ~ Include TIFF-CMYK format (30% of the JPEG scan price above) $ ______________ . ~ Duplicate sets: ______ additional disc copies x $7.00 = $ ______________ . ~ Storage case with custom cover: add $15.00 (fill in title and slide number below) $ ______________ . ~ Additional storage cases with custom cover ______ x $7.00 = $ ______________ . Subtotal ($50 minimum) $ ______________
. ~ Rush fee (see rates below) $ _______________ . ~ Repeat Discount (save 10% of subtotal above) / Your last order/receipt #__________. $ -_____________ . ~ Space rental (see rates below) $ ______________
. S&H for scans to US ($7.95 Ground, $17.95 Air) $ ______________ . S&H for returning slides to US ($5 per pound) $ ______________ . ~ Insurance (add $2.00 per $100.00 value on returned slides) $ ______________ . TOTAL (US funds) = $ ____________ . Thank you!
Payment: Check enclosed, payable to Wheeler Arts (sorry, Money Order not accepted).
Required: I/we, (print name/names)______________________________________________________, am/are legal owner/owners of the enclosed slides and grant Wheeler Arts permission to scan them. I/we retain all rights to the slides, their scans, and those images. Wheeler Arts will not release such slides, their scans, or copies to another party. . Signature(s): ______________________________________________________ Date: ______________
I have numbered the enclosed slides and included a corresponding list of scanning instructions. Number of slides: ____. . Windows to be scanned (check one): ___All pairs, ___All left, ___All right, ___Other per my instructions / list attached . Cropping scans (check one): ___Full frame, ___Crop edges . Media (check one disc format): ___CD, ___DVD . Total number of disc sets: ___
Storage Case with Custom Cover: . Cover title (print clearly): ____________________________________________________________________ (50 characters max) . Cover slide #______ (put a "0" here if you would like a white background instead of a scan) My order (subtotal) is $200 or more, with standard turn-around time. I am eligible for the Special! -- 1 free storage case with custom cover (put $0 in blank above instead of $15.00).*