Print Form
ENCLOSING THIS FORM WITH YOUR PACKAGE WILL EXPEDITE YOUR ORDER AND REDUCE COSTLY PROCESSING ERRORS.
IF POSSIBLE, PLEASE SEND A SAMPLE OF THE FINISH YOU NEED.
YOU MAY EITHER:
1. Print form, fill in by hand, and enclose form with order.
2. Fill form on computer by clicking on blank spaces to enter information, print filled form, and enclose with order.
Company Name
Contact Name
Street
Phone
City
Fax
State
Zip
e-mail Address
Date Sent
Date Needed
MC
2 Day
1 Day
Ship UPS
Visa
Discover
3 Day
Insurance Value $
Other
Ground
3-digit code
Exp Date
CC#
Name on Card
Signature
CC Billing Address if Different
DO YOU WANT US TO KEEP THIS CC INFORMATION ON FILE FOR FUTURE ORDERS
GROUP #1
NO
GROUP #2
1. Total number of pieces sent
OR
Weight
1. Total number of pieces sent
OR
Weight
2. Parts are made of
2. Parts are made of
3. Plated parts are to be (check one):
3. Plated parts are to be (check one):
SHINY FINISH
SATIN FINISH
MAINTAIN EXISTING FINISH
SHINY FINISH
SATIN FINISH
MAINTAIN EXISTING FINISH
4. Final finish should be (check one):
4. Final finish should be (check one):
14K GOLD
18K GOLD
24K GOLD
14K GOLD
18K GOLD
24K GOLD
ROSE GOLD
GREEN GOLD
RHODIUM
ROSE GOLD
GREEN GOLD
RHODIUM
SILVER
NICKEL
COPPER
SILVER
NICKEL
COPPER
OTHER
OTHER
5. Thickness of GOLD
5. Thickness of GOLD
6. Special instructions
6. Special instructions
•
•
•
•
YES
$100 MINIMUM PER ORDER.
FOR ORDERS WITH MULTIPLE FINISHES WE HAVE A $50.00 MINIMUM FOR EACH FINISH WITHIN YOUR ORDER.
A 5% HAZARDOUS WASTE FEE IS ADDED TO ALL INVOICES.
$5.00 SHIPPING, HANDLING, AND INSURANCE IS ADDED TO ALL SHIPPED ORDERS.
630 Oak Street SE • Albuquerque NM 87106-5524 • T 505-243-6600 F 505-246-8880