To order, fill in this form,
print it out and bring or mail it, your photo and the amount of
your order to:
URBAN CITY
11617 West Montgomery Road
Houston, Texas 77086-4114
Your Senior e-Cards will be
delivered to you within 2 weeks.
Price - Senior e-Cards are sold
in quantities of 60. The cost is $45 per 60. You can order
as many as you would like to, but you must order in increments of 60
(i.e. 60, 120, 180, etc.).
1. Name of high school
you attend
2. Your "Nickname" if you have one
3. Are you a Senior? If not, what grade level are you?
4. Any school affiliation that you would like to have listed here
5. Any school
affiliation that you would like to have listed here
6. University, College or Branch of Service you will be attending
7. Your complete name goes here
8. Your graduation year goes here
9. Your e-mail address is
If you don't have an e-mail address, do you need
assistance in setting one up? yes or no
10. We need a contact telephone number for you in case we have
further questions. Give us a contact number here. Don't forget
to include your area code.
