Customer Information

First Name of Person to Contact:

Family Last Name:

Street Address:

City: State: Zip Code:

Home Area Code: Home Phone Number:

Please give an alternate phone number (cell number/work number) where we can contact you.

Alt. Area Code: Alt. Phone Number:

E-Mail:

Appointment Information

Studio is open from 9am - 8pm, 7 days a week for appointments

Enter your 1st choice for Appointment Date and Time that you would like.

1st Choice Appointment Date: 1st Choice Appointment Time:

Enter your 2nd choice for Appointment Date and Time if your 1st choice is not available.

2nd Choice Appointment Date: 2nd Choice Appointment Time:

Please assist us in scheduling your appointment by answering the questions below:

1. What type of Portrait will we be doing? SelectHoliday PicturesFamily PortraitCommunion PortraitConfirmation PortraitSchool PortraitChildren's PortraitOther

2. How many people will be in the picture? Select 1234567Other

3. Which background would you like to be photographed on?

4. Have you been to EAP Photo Service before to have your pictures taken? SelectYesNo

5. Were you referred to EAP Photo Service by anyone? If so who?

6. Did you find our service in the Yellow Pages or on the Internet? SelectYellow PagesIternetOther

7. Do you have any Questions or Comments?



After pressing the submit button you will be presented with a Thank You Page confirming your request. You will get an email or a phone call from our scheduling department within 24 hours.

Portrait Studio On Line Appointment Request Form

Instructions:

1. Fill in the information below and then submit your request.
2.You will receive an email or a phone call from our scheduling department within 24 hours.

QUESTIONS ???
631-476-0134
Mon-Fri 9am-5pm EST

All blanks MUST be filled in for us to complete your request