1924 Raymond Drive
Northbrook, IL 60062
Phone: 800-506-7966 / Fax : 206-237-2976
www.crystalartusa.com
ORDER FORM    print and fax to 1-206-237-2976

Order No:    Order Date:        /      Purchase Order#:   
Billing Information - credit card billing address
Customer Name:     
Company Name:     
Street:     
Street 2:     
City:     
State & Zip:     
Phone:     
Email:     
Shipping Information
Customer Name:     
Company Name:     
Street:     
Street 2:     
City:     
State & Zip:     
Phone:     
Email:     

Payment Information
Payment Type (check one):   [  ]Visa  [  ]American Express  [  ]MasterCard  [  ]Money Order  [  ]Corporate Check
Card Number:  
CVV2 Code (on back of card):   Card Expiration Date:  
Card Holder Name:   Card Holder Phone Number:  

Shipping Information
Shipping Type:   [  ]Next Day   [  ] 2Days   [  ] 3Day   [  ] Ground   Shipping charges will be added to your total.
Special Instructions
Is there a deadline for your project? (please provide date) ___________________
Allow 14 business days for standard orders. For rush orders call 773-531-2202.

Email logos, graphics files, and personalization text to graphics@crystalartusa.com

Items
Inventory #   Product Description/Size   Engrave Logo       Qty       Price per Unit     Total    
      [  ] Logo&Text [  ]Text        $   $      
      [  ] Logo&Text [  ]Text        $   $      
      [  ] Logo&Text [  ]Text        $   $      
      [  ] Logo&Text [  ]Text        $   $      
      [  ] Logo&Text [  ]Text        $   $      

Totals
Sub Total:   $            
Sales Tax * 0.09 (Illinois ONLY):   $            
Logo/Artwork Setup Fee (camera-ready $35.00/ other formats $75.00) if applicable         $            
Total:   $            
All sales and orders are final. Our merchandise can not be returned. There are no refunds once your order is in production.
If you have approved the artwork for your custom order, your order is in production and cannot be cancelled.
Crystal Art USA, LLC. does not take financial responsibility for the incorrect spelling of personalization text provided by
the customer. It is the customer's responsibility to spell check and proof read personalization text prior to submitting their orders.
You are responsible for the charges you have authorized. By signing this form you agree to these terms for your order.


Signature_____________________________________