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Alan's Custom Lab
1642 Wilcox Ave  -   Hollywood, CA 90028    (323) 461-1975 Bus  (323) 461-9840 Fax  

    
Black & White FILM PROCESSING ORDER FORM

   1             Customer Information

  2                  Shipping Information
 Name  Name
 Address  Address
 City  City
 State                                              Zip  State                                            Zip
 Area Code & Phone 

  3           how to ship your order 
 Email Address

4  Payment Method  (Put an X by appropriate payment)
Credit Card______   Money Order______  Cashiers Check______  Check (*)______
*Regular checks must clear the bank before we can ship orders. This may take as much as 10 days. 
Please download a Credit Card Payment form.

5   Black & White Film Process Order Form

# of Rolls

Film Size

Type

# of
Exposures

ASA

      ASA Change
      		Machine Prints
  

Extra
Proofs
35mm 120 + - Yes No
                     
                     
                     
                     

                        6    Special Instructions

7     Machine Prints
Size X Number of
copies per 

  Paper Surface 

Borders

 Special Instructions
G P M W W/O SBL

3½x5

                

  4x6

                

8   OFFICE USE ONLY
Received Completed Shipped FedEx UPS Priority Mail Other