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PERSONALIZATION ORDER FORM

Please print, fill out & mail to address at the bottom of this form.
 
     Personalization Information:
                     ● Fill out your name & address below as you would like to see it on your signs.
                     ● 3 lines 17 characters or spaces per line. (Please Print Clearly)

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                     ___  ___  ___  ___  ___  ___  ___  ___   ___  ___  ___  ___  ___  ___  ___  ___  ___

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     Sign Color:
                     ● Please Circle Color and Write Quantities required.

                        Orange:_______     Yellow:_______    Neon Green:_______    Purple:_______

     Pricing & Delivery:
                     ● There is an additional $25.00 set up charge on Personalized orders of less than
                        100 pieces of the same color and name.
                     ● Price for each sign.  $1.50
                     ● Free shipping to purchased location.
                     ● Please allow 1-2 weeks to process your order.
                     ● SPECIAL NOTE: Personal Checks Allow an additional 8 to 10 weeks for clearance.

     Shipping Address:  ____________________________________________________________________

                                                    ____________________________________________________________________

                                                    ____________________________________________________________________

                      Phone Number:  (______) -________-__________________

     Payment Options:   Circle One:      Card Number: ____________ - ____________ - ___________ - ____________

                                                   Expiration Date: ________________   Print Name:__________________________________________

                                                   Signature: _________________________________________________  

                                                   Personal Check: (See Special Note under Pricing & Delivery)  ________        Money Order: ________

       Order Calculation:  Quantity ______ X $1.50 =___________ + Personalization less than100 pieces $25.00 circle one YES NO

                                                  + New York State Residents add  8.75 % Sales Tax ____________  = TOTAL $_________________
 


MAIL TO:  C & C Innovations, Inc.
          6579 Bartlett Road
          Rome, NY     13440