Photo Impact Order Form
Order directly via US Postal Mail. Fill out form, send your picture along with payment.

After printing, complete this form and mail with your remittance to:

Northwest SilverSmithing and Ceramics
5010 South Yakima
Tacoma, WA 98408

Ship to:

Name: __________________________

Address: ________________________

City: ___________________________

State, ZIP: ____________________

Dog Tag/Type Ordered: ____________________
Washington Residents add
sales tax 8.8%: ___________________

Shipping: ________________________
US Postal Service - $7.99 per Tag Priority Mail Only
Add 25cents per extra tag-- We will only ship these photo tags Priority Mail with Tracking and insurance- This is do to the value of your product and to insure you receive it- Please note that several tags can be sent for that priority mail price- Thanks John

Total: ___________________________
Visa/MasterCard/American Express/Discover or Paypal Accepted --our paypal account is artisian@foxinternet.netAccount #: _________________________

Expiration Date: ____________________

Authorization Code on back of card- last three digits_____________ Must place this code or the card will show a mismatch and hold up the order until we can verify                              

Signature: _________________________