Masak Pottery - Personalized Order Form

masakpottery.com	2009 personalized order form

	After we receive your order, we will contact you by email with confirmation, shipping date and payment arrangements. (we accept checks via mail or any major credit card over the phone). Delivery can be made to you or the recipient. Upon delivery to recipient, a note or email including a picture of the finished piece will be sent to you to inform you the gift is on it's way. Don't hesitate to call or email if you have any questions. Thank you for ordering from us! Dwight & Regina Masak

	If you do not receive a confirmation within 48 hours, please contact us by email or phone... If you would rather call with the information - please do so! Thank you.

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Personalized Order Form

Design Lettering:
Lettering to be on top in the band:

Lettering to be on bottom in the band:

Choose one shape:
14" Flat Bowl     14" Platter

Choose one main body color:
   (These color choices will have a cream band except for All Black)
   (Only All Black has the option of a color in the center of the piece)
    Cobalt Blue     Black     Green     Purple     Burgundy
    All Black with color in center - Check a center color...
                                                Cream     Green     Burgundy

Choose Design:
    Tulips (traditional)     Wheat     Daisy     Grapes     Roses     Leaves (new favorite)
    Other Design (describe design)

        • Please indicate color for the design you chose:

***Anniversary Date for center if applicable: (ie: 25th, 50th)

* Now included in the price ...
You can have a personalized message permanently written on the back of the piece (up to 60 characters).
(ie: "May your plate always be full! Love, Bob & Jan")

Ordered By:
First & Last Name:

Street Address:
    Apt.#
City:

State:

Zip:

Phone Number (include area code):
   •Home Phone:    •Work Phone (optional)
Email Address:

   • Extra Shipping Charges may apply to a P.O. Box or outside of the continental U.S.

Ship to (if different from "Ordered by"):

Shipping Address:
Apt.#
City:

State:

Zip:

Phone Number (include area code - for shipping purposes only):

Message on Gift Card (ie: Best Wishes, Jacob & Elaine):
(We will include an unsigned card if the piece is being shipped to you.)

Date Needed:

Please let us know how you found us:
An art show? A friend? Internet? Received as a gift?
Other:

Please include any other information you would like:


Click the Submit Button when order is complete. Thank You Again, The Masak's