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TO VIEW PICTURES ON LINE DO NOT FILL THIS
FORM OUT!   INSTEAD GO TO;
For a wedding the event code will be the groom's last name.
For family or senior shoot, the event code will be your last name.
 
FOR INFORMATIONS ABOUT A WEDDING, SENIOR PICTURES
OR FAMILY PORTAIT, FILL THE FORM OUT BELOW AND
SEND IT INTO MY STUDIO.  THANK YOU.
 
                    Contact Me
 
            Phone:    937-596-6264
            Cell   :     937-726-5756
                            or
       e-mail:    rleininger@woh.rr.com
 
Address:   P.O. Box 538
               210 Cole street
               Jackson Center, Ohio 45334
 
   ***NOTE BELOW***
 
           Please fill out the form below
 
                                 OR
 
     SEND ME AN E-MAIL WITH YOUR
            QUESTIONS OR NEEDS.
 
            
In your comments, please include:
    1.  What you are in need of;                   
     2.  If you are getting married;              
         a.  date and place of your wedding.
                        
First Name:
Last Name:
Company:
Email:
Phone:
Address 1:
Address 2:
City:
State:
Zip:
Comments: