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            SPECIAL OCCASIONS 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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Special Occasion Items
How it works:  1. Select the items you want to order.
               2. Fill out the order form.
               3. Get your logo and this form 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
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BIRTH CERTIFICATES
     Boy (blue)_____     Girl (pink)_____
 
     Name________________________________________________________________
 
     Date _______________________________________________________________
 
     Weight______________________________________________________________
 
     Length______________________________________________________________
 
                                                = _____ x 40.00 = _______
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AFGHAN (50" x 60") American made woven natural color
 
     Heart Design_____         Waffle Design_____
     
 
     Wedding Date Afghan Names_________________________________________
 
                         Date__________________________________________
 
                         Flowers_____ Bells_____ Church_____ Plain_____
 
     Anniversary Afghan  Names_________________________________________
 
                         Date__________________________________________
 
                         Flowers_____ Bells_____ Church_____ Plain_____
 
     Birth Afghan        Name__________________________________________
 
                         Date _________________________________________
 
                         Weight________________________________________
 
                         Length________________________________________
 
                         Boy (blue thread)_____ Girl (pink thread)_____
 
     Family Name         Name__________________________________________
 
                         Thread color__________________________________
 
     Two Hearts          Name____________________Name__________________
  
                                               = _____ x 40.00 = _______
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BRIDE & GROOM HATS
 
     Hats _____
 
     Names (optional $5 each)   Bride_______________ Groom_______________
 
 
                                                = _____ x 20.00 = _______
 
                                        names   = _____ x  5.00 = _______
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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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