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ATKINS MEDIA ORDER FORM

Your Photographer

Kevin Atkins

+ Travel Fee

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Property Information

Address*

City*

State*

Zip Code*

Square Feet

MLS Number

Bedrooms

Bathrooms

Lot Size

Appointment Time

Please select an appointment date and time.

Account Information

Email*

Name*

Phone*

Company

Referral Code

Project Details

Drivability (property access)

How will I access the property?

Key box code (and/or gate code)

Is the home vacant?

Yes No

Are there any specific features you’d like to showcase?

Do you want a photo of the garage?

Yes No

Additional Information

Please enter anything else we may need to know (i.e. gate code, special feature of the home to make sure we get, etc.)

Payment Information

Travel Fee

Sub-Total

Sales Tax

Travel Fee

Order Total

Allowance

Payment Required

Due Today

All amounts are in USD

Promo Code

Billing Information

Address*

City*

State*

Zip Code*

Credit Cards on File

New Credit/Debit Card

Keep this card on file for future use

Send me an Invoice

No Payment Due

Atkins Media

(865) 221-7299

kevin@atkinsmedia.biz