on behalf of YOUR ORGANIZATION'S NAME


We are honored that you have chosen to visit our studio. 

Please fill out this form to reserve one gift certificate for your family.  Your credit card will be charged directly by ORGANIZATION'S NAME, not by our studio.

This gift certificate is for a Family or Children's Portrait Session, and a Framed 12.5x12.5 Canvas Portrait.  Please click here for important details and restrictions.

BY SUBMITTING THIS FORM, YOU AUTHORIZE A $295/$495 DONATION TO BE CHARGED ON YOUR CREDIT CARD.  Once this non-refundable donation has been charged, we will mail you a gift certificate directly.  The gift certificate is not transferable, but you will be protected even if your physical gift certificate is lost or stolen.

What is your name? *
What is your name?
Where should we mail your gift certificate? *
Where should we mail your gift certificate?
What is the best phone number to reach you at? *
What is the best phone number to reach you at?
If you prefer, you can provide this information by telephone. Just let us know at the bottom of this form.
This is the three our four digit verification code.
Credit Card Billing Address (only if different from your mailing address)
Credit Card Billing Address (only if different from your mailing address)