Use this form to order Konica photo specialty items not listed on your Software of the Month Club® Film Club Mailer. 

Please fill in your name, address and phone number along with the items and quantities you wish to order and then include this order form in your Film Club Mailer. It’s that simple! 

For additional photo product information call Konica’s KQPW Customer Service Department at 1 (800) 955-6642 or (714) 549-0500.

Please write Special Order Form Enclosed on the outside of your Film Club Mailer.


Name ______________________________________________________________

Address ___________________________________________________________

City _____________________ State ________________ Zip _____________

Telephone (   ) ___________________________________________________

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Item 			Cost 			Quantity 			Total 

_______________________________________________________________________
_______________________________________________________________________
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_______________________________________________________________________
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 	 Sub Total _____________

 UT, WA, CA Residents add 7.75% Sales Tax _____________

 Shipping & Handling _____________

 Total _____________