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Keyboard and Mouse

MMC Form Template

QR Code
PLACQUE

for your website -
or to e
mail you


 


Please fill out the information below.  You will get an email with the design, so you can make sure the QR CODE is taking the visitor to the correct place.

Already a Lo
 

Your

IMAGE #1
Upload supported file (Max 15MB)
IMAGE #2
Upload supported file (Max 15MB)
PHOTO OF ARTIST
Upload supported file (Max 15MB)

Please keep this to a recognizable face.  No sunglasses, etc.  THANKS!!!

Release:  This will be used for our tv reader board, social media for this theme and other items that publicize you as an artist for this theme.  By submitting your photo, you grant permission for this specific use.

IMAGE #3
Upload supported file (Max 15MB)

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© 2019 Lydia Crouch. Site created by Adprompt Media using Wix.com

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