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            COMPANY LOGO Mail or Fax Order Form
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Please fill out completely: Date_________________
 
 
Name______________________________________________Phone_________________
 
SHIPPING ADDRESS
 
 
Name____________________________________________________________________
 
Address_________________________________________________________________
 
City_____________________________State__________________Zip_____________
 
Country_______________________________Phone_____________________________
 
EMail (optional)________________________________________________________
 
Method of Payment    Check/Money Order _____  Master Card       _____
                     Visa              _____  Discover          _____
                     American Express  _____
 
     Credit card Number ______________________________  Exp date ________
 
     Cardholder Name    _________________________________________________
 
     Billing Address    ______________________________  Zip _____________
 
     Signature          _________________________________________________
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Item                                               Qty    Price   Total
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COMPANY LOGO SPECIAL
How it works:  1  Select the items you want your logo on:
                   -minimum initial order is:
                        -five shirts -or-
                        -five briefcases -or-
                        -ten hats
               2  Once the minimum is selected, feel free to order any
                  quantity of the other items.
               3  No minimum on reorders.
               4  Get your logo to us by one of the  following means:
                   - Email to info@EmbroideryCreations.com
                   - Fax to 937-235-0487 (include colors)
                   - Stop by our Huber Heights location 937-235-0441
                   - Mail info to:  Embroidery Creations
                                    5050 Nebraska Ave. Ste. 9
                                    Huber Heights, OH  45424
               5  Mail or fax this form to us (fax 937-235-0487)
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Your logo on a Jerzees polo shirts(colors and sizes may be mixed):
Adult sizes   SM   MD   LG   XL        2X
 
       Red  |    |    |    |    |    |    |
 
     White  |    |    |    |    |    |    |
 
     Royal  |    |    |    |    |    |    |
 
      Navy  |    |    |    |    |    |    |
 
     Black  |    |    |    |    |    |    |
 
    Forest  |    |    |    |    |    |    |
 
   Lt Gray  |    |    |    |    |    |    |
 
   Natural  |    |    |    |    |    |    |
 
S-XL Totals  ____ ____ ____ ____                = _____ x   20.00 _______
 
2X Total                              ____      = _____ x   23.00 _______
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Your logo on Outer Banks Pique polo shirts(colors and sizes may be mixed):
Adult sizes   SM   MD   LG   XL        2X
 
       Red  |    |    |    |    |    |    |
 
     White  |    |    |    |    |    |    |
 
     Royal  |    |    |    |    |    |    |
 
      Navy  |    |    |    |    |    |    |
 
     Black  |    |    |    |    |    |    |
 
    Forest  |    |    |    |    |    |    |
 
   Lt Gray  |    |    |    |    |    |    |
 
S-XL Totals  ____ ____ ____ ____                = _____ x   25.00 _______
 
2X Total                              _____     = _____ x   28.00 _______
 
Names        ____ ____ ____ ____      _____     = _____ x    5.00 _______
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Your logo on hats (colors and styles may be mixed):
 
Profile      Std  Low
 
       Red  |    |    |    
 
     White  |    |    |
 
     Royal  |    |    |
 
      Navy  |    |    |
 
     Black  |    |    |
 
    Forest  |    |    |
 
   Lt Gray  |    |    |
 
Std Total    ____                               = _____ x  9.50 = _______
 
Low Total         ____                          = _____ x 11.00 = _______
 
Names        ____ ____ ____ ____      _____     = _____ x    5.00 _______
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Your logo on briefcases (colors may be mixed)
 
 
      Navy  |    |
 
     Black  |    |
 
    Forest  |    |
 
 
    Total   ____                                = _____ x 26.00 = _______
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     Total number of items _____                            Total________
 
     Shipping =$5 for first item plus $1 per additional  Shipping________
 
                                                        Subtotal ________
 
                                  Tax (Ohio residents only 7.0%) ________
 
                                              Total Order Amount ________
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