* Required Field--------------Please provide the following  CONTACT and  SHIPPING  Information:

Name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
FAX
* E-mail
URL-http://www.

Please provide the following information regarding Formatting and Image Use:

Resolution Configuration	150 pixels/inch (multi-use) 300 pixels/inch (print) 500 pixels/inch (fine print) 48 bit color-Indicate desired Resolution in "Special Instructions Box" Other Resolution, Indicate in "Special Instructions Box" -at 72 MB (6144 x 4096 pixels)
Operating Platform	PC MAC

CUSTOM SCANS are 24-BIT RGB Full Color (expressing 16.7 million colors); unless 48-BIT RGB Color IS REQUESTED above, which doubles file size.

Please choose SIZE and COST of IMAGES-

72 Megabyte-Pro Scan-$ 99.98 each. 144 Megabyte-Custom Scan- $ 149.97 each. 288 Megabyte-Custom Scan-$ 199.96 each. Price Includes USPS Air Priority;  AND  Delivery Tracking & Confirmation.

Delivered on  Kodak Ultima ® CD-ROM Compact Disc with Jewel Case.

 In California please add 7.25% to the total.

For NEXT DAY AIR OR  Delivery outside the USA; please add $9.00 to total.

Please provide the following Ordering Information:      (How to Find Image Numbers)

Image Number	DESCRIPTION

BILLING Choose one of the following Payment options: Send Check Online Credit Card / Check Debit Transaction ANTHROARCHEART.ORG; P.O. BOX 591196 SAN FRANCISCO, CA. 94159-1196

Royalty Free	LICENSE INFORMATIONCHECK if same as ABOVE
NAME
Street Address
City
State/Province
Zip/Postal code
Country

Images are processed and shipped within 24 hours of  ONLINE CREDIT PAYMENT or RECEIPT OF CHECK.

Enter any SPECIAL INSTRUCTIONS below: (Additional Image Numbers, Company Fed Ex Account Number, Request 48 bit color output).

Be Sure To SUBMIT This FORM

            Please be patient, processing this form may take a few minutes! THANK YOU