dr5-FILM LAB     Scanning      FILMSCANS.NET            date___________
111 NW 2ND ST, STUART, IA, 50250
BOX 580, STUART, IA, 50250 [us mail]
email: info [at] dr5.com  515.523.8375   LAB RATES HERE
1) original art___________________________________________format_______
2) original art___________________________________________format_______
3) original art___________________________________________format_______ 
YOUR PROCESSED FILM        ROLL SCANS W/PROCESSING
ROLL SCANS:(35mm + 120)
SMALL [5~6mgb]        MEDIUM 10~12mgb]       LARGE [17~19mgb]    
XX-LARGE [35~40mgb]   X-LARGE [25~30 mgb]   LF SCAN: DIGITAL CONTACTS [ apx.150mg]

DRUMSCANS          PREMIUM SCANS     ROLL-SCANS
BULK 35mm-SLIDE SCANNING:              Go to FILMSCANS.NET for our bulk rates.
Individual SCANS DPI________________________________________________ or
                                 % PERCENTAGE_____________________________________ or
                                 FINAL DIMENSION ___________________________________
SCAN-saved as:     MAC    PC    
FORMAT:   tiff          jpg          psd-photoshop     eps
other____________________________________________________________

PHONE & EMAIL IS REQUIRED.  PLEASE WRITE IT CLEARLY, THANKS.

Phone #: ____________________      EMAIL __________________________________

Name & Shipping Address_________________________________________________

______________________________________________________________________

_______________________________________________________________ _______
SHIPPING:   Business address   Residential address   INTERNATIONAL
USPS - DEFAULT
1st-CLASS - 2~5 days        PRIORITY - 2~3 days         EXPRESS
1st-Class w/track International - to 3lbs /  Domestic - 13oz         UPS / FEDEX - CALL
 or UPS / FEDEX - Account  SHIP number ____________________________________

PAYMENT:  VISA . AMEX - MASTERCARD . DISC .    PAYPAL(4% - fee)  info@dr5.com
CHECKS-PAYABLE TO dr5  CHECKS MUST INCLUDE RETURN SHIP.
C/C ACCOUNT #________________________________________EXP. DATE________

[REQUIRED] CVV2 CODE 3-digit number on the back of card.______3% fee for zip/address mismatch

CC BILLING ADDRESS# & ZIP [IF DIFFERENT]_________________________________
LIMITATION OF LIABILITY :  No warranties implied. All care is taken to achieve quality results.The limitation warranty also does not cover any losses or damage
that may occur due to an act of nature or shipping. .dr5-chrome will compensate for any loses on a case by case basis, or loss due to neglect.