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            COMPANY LOGO Order Form
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Please fill out completely:     Date


NamePhone

SHIPPING ADDRESS


Name

Address

CityStateZip

CountryPhone

EMail  

Method of Payment    Master Card    Visa  
                     Discover       American Express
                                                                     

     Card Number   Exp date 

     Cardholder Name    

     Billing Address     
                    Zip 

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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 sales@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  Submit, Mail or fax this form to us (fax 937-235-0487)
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Your logo on a Jerzees polo shirts(you may mix colors and sizes):
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(you may mix colors and sizes):
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 
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Your logo on hats (you may mix colors and styles):

Profile      Std  Low

       Red  
     White  
     Royal  
      Navy  
     Black  
    Forest  
   Lt Gray  

Std Total                                        x  9.50 = 
Low Total                                        x 11.00 = 
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Your logo on briefcases (you may mix colors)

      Navy  
     Black  
    Forest  

    Total   =                                 x 26.00 = 
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     Total number of items                  Total
     Shipping =$5 for first item plus $1 per         Shipping
                additional item                     Subtotal 
                              Tax (Ohio residents only 6.5%) 
                                          Total Order Amount 
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