GIFTS OF HEALTH,  LAMP ORDER FORM, FALL 2009

Y

N

# OF PIECES 12 or  more   except  x-lge

LAMP

SIZE

PLAIN

 

each

WITH

EMBLEM

COLOR

each

ADD

NAME

 

each

ADD

FULL

DATE

each

ADD

YEAR

 

each

ADD CLASS

OF

each

ELEC 

CANDLES

 

each

ADD

SHIPPING per lamp

each

RES.

DELIV.

PER BOX  each

Indiv. lamp

Total

each

TOTAL

Order

 

X- LARGE

42.50

54.95

6.00

5.00

3.50

6.00

6.00

15.00

10.00

 

 

 

LARGE

14.75

22.50

3.50

3.00

2.00

3.00

3.00

1.45

10.00

 

 

 

MEDIUM

9.25

16.25

3.50

3.00

2.00

3.00

2.50

1.25

10.00

 

 

 

MINI

7.50

13.25

3.50

3.00

2.00

3.00

2.50

1.25

10.00

 

 

ARTWORK

FROM  SCRATCH

OUR © DESIGN

*

 $50.00

YOUR

DESIGN        *

$85.00

TOUCH  UP YOUR

EXISTING             DESIGN

$20.00 Per Hour

CAMERA READY EMAIL

.TIF/ .JPG / .GIF / .PDF file design

NO ART CHARGES

 

 

*YOU  MAY  NOT  USE  ANY COMPONENT OF OUR COPYRIGHTED DESIGNS  WITHOUT  PERMISSION,  EXCEPT YOUR SCHOOL / ORG./ CORP.  NAME

*YOU MAY  USE  YOUR OWN CREATED  OR EXISTING DESIGN AT WILL. YOU  DO NOT  NEED A RELEASE

TODAY’S DATE

 

 

 

REQ. DELIVERY DATE

 

 

 

CEREMONY DATE

 

 

 

PURCHASE ORDER #

 

RUSH ORDER

Rush Charges will apply

NEXT  DAY   AM

NEXT DAY

SAVER

2 DAY

AIR

 

 

 

SCHOOL  OR

HOSP/BUS.

 

DEPARTMENT

 

DEPT.

CONTACT

 

DEPT.  PHONE

 

DEPT. EMAIL

 

SHIP TO

ADDRESS

 

BUILDING /

ROOM  #

 

CITY & STATE

 

ZIP

          RES. ?

STUDENT REP

 

CARD #

 

 

 

 

EXP DATE

 

CODE  #

 

CARD NAME

 

ADDRESS

 

ADDRESS

 

CITY &

STATE

 

 

ZIP

 

AUTH  #

CARD HOLDER’S

PHONE  #

 

 

 

E MAIL

 

Signature