Memorable Moments Request Form

Contact Information
First Name:
Last Name:
Address:
City:
 State:
 Zipcode:
Email:
Phone:


Order Information
This order is for the restoration of a:
 Person Scene (Landscape/Seascape) Biblical Other
I would like this to be painted with:
 Pastel Acrylic Oil Watercolor Other
What size would you like:
Type of background desired:


If the Photo That You Would like Restored Is a Black and White Photo, Please Answer the Following Questions
Color of Hair:
Color of Eyes:
Complexion:
Color of Clothes:
How many persons?
Bust Only?  Yes No
Half Body?  Yes No
3/4 Body?  Yes No
Whole Body?  Yes No
Group of People?  Yes No


I request 50% upon start of project and 50% at end of project. Payments in the form of Money Orders, Cashiers Checks or Personal Checks are accepted and must be made out to Felipe Luis Alvarez.

Note: When the project is near completion, I will render a copy for your approval and/or corrections.