YOUR COMPANY NAME
YOUR EMAIL ADDRESS
CONTACT NAME
PUBLICATION NAME

DATE OF PUBLICATION
NAMES OF IMAGES REQUESTED
PUBLISHED SIZE
1/4 pg 1/2 pg full pg spread cover
1/4 pg 1/2 pg full pg spread cover
1/4 pg 1/2 pg full pg spread cover
1/4 pg 1/2 pg full pg spread cover
PREFERRED SIZE OF DOWNLOAD IMAGE
X Pixels Inches

DO YOU NEED A HIGHER RESOLUTION THAN 300 dpi?
No Yes - Please specify dpi

ADDITIONAL COMMENTS OR QUESTIONS

PAYMENT METHOD

PAYPAL/CREDIT CARD (thru PayPal Only)
We 'll send an email with your total due and a link to make the payment through PayPal.
CHECK or MONEY ORDER
We will email you the mailing address
to send the payment to.



AFTER PAYMENT IS RECEIVED WE WILL EMAIL YOU THE LINK TO DOWNLOAD YOUR IMAGE(S)

 
Copyright 2010 Marilynn Flynn - Tharsis Artworks
No part of this website may be reproduced in any manner or media without permission.
REQUEST FOR PUBLICATION FORM
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