ORDER FORM

To place your order select a Product in the drop down Menu. Next select the Quantity you desire. Then type what you would like to have engraved on your item and last, select the font for your engraving. Your email address is required so a proof can be sent prior to engraving


If you would like us to engrave a corporate logo, hand written message or design, please submit design via Email in black and white in either .jpg or .cdr (corel draw) formats. In your email please include your name and address so we could cross reference to the order form.

North Carolina residence or individuals shipping to North Carolina must check the sales tax box.

In-stock items will be shipped within 3-4 weeks. For rush deliveries and pricing, please call toll free 877-580-5984.



Product
Qty
Unit Price
Ext Price

Please enter the information you would like engraved including, but not limited to; Wedding invitiations, Monograms, names, poems etc. If you would like us to engrave a logo or other special image, please email a black and white image and include your name and address so we can cross reference the item with the order form.

Item 1
Item 2
Item 3

Subtotal:

Shipping:

Check this box if you live in or are shipping to NC.

NC Sales Tax:

(more below)

Grand Total:

Bill To:

Name:

Company:

Address1:

Address2:

City, State, Zip:

Day Phone:

Evening Phone:

Email address:

Credit Card: VISA Master Card

Expiration Date:

Credit Card Number:

Cardholder's name as it appears on card:

Ship To:

Name:

Company:

Address1:

Address2:

City, State, Zip:

Thank you for your order! If you have a comment or would like further information, please call 877-580-5984, or email: csendek@memoriesonabottle.com. Packages will be sent by UPS within 3-4 weeks.