Fun question Mel, and it's fun to see everyone's processes.
For me it is always the photo first and then the background paper. The last thing I usually add are three little brads...I think it's my way of telling myself the page is done and quit over thinking it!!
Camera: Nikon D90, Nikon D50
Lenses: Nikkor: 50 mm 1.4, 24-70 2.8, 70-200 2.8, Micro 60mm 2.8G ED, 18-200mm VR, SB-800
Software: Adobe PSE3 and CS2
Computer Platform: It may be a PC, but at least it's fast
My camera gear: Nikon D5000, Lenses - Nikon 50mm 1.4 (LOVE!), Tamron 18-200mm 3.5-6.3, Nikon 28-80mm 3.3-5.6
Software: PSE 13