pinable.com - order form
Print this form , complete all information, and fax to 623-266-7318 or print and mail to: pinable.com - 1067 E US Hwy 24, #261 Woodland Park, CO 80863
Lapel pin size: 1/2" 3/4" 1" 1 1/4" 1 1/2" 1 3/4" 2" SPECIAL SHAPE ____
Metal finish: Antique Bronze Antique Copper Shiny Silver Antique Silver Matte Silver Shiny Gold
Antique Gold Matte Gold Nickel Matte Nickel Black Nickel Rhodium Imitation Rhodium
Color: None 1 side (8 or less on one side)
Process: Die Struck Iron Stamp Resin Epola Photo Etch Silk Screened Best option chosen by pinable.com
Extra colors: How many? ________ (If silk screening is desired, please circle silk screening and place the number of colors as extra colors.)
Features: (Please circle or check those that apply for your coin.)
EPOXY SANDBLASTING CUTOUTS: ____ (How many?) PHOTOGRAPHIC PRINTING
TWO TONE PLATING (for Shiny and Matte metal coins) SPOT PLATING (for Antique metal coins) SILK SCREENING
Special paint: PEARLESCENT GLOW HEAT CHANGING TRANSPARENT # ____
Options: Key Chain Tie Tack Tie Bar Cuff Links Pendant Other ____________________
Customer ID________________________________ (assigned by pinable.com) We accept :AMEX / VISA/ Master Card/ IMPAC
____ New Order ____ Reorder Amount Being Charged:$______________ Promo Code:_______________________________
ORDER TYPE: ____ REGULAR, NO sample ____ RUSH ORDER (additional fees apply)
| Credit card#: |  |
| Exp Date: |  |
Name on card: ___________________________________________________
Billing address: __________________________________________________
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Shipping Address: (Same?___) __________________________________________________ BLIND ____
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Telephone Number: (day)_____________________________ ( ____ evening or ____ cell)_____________________________
e-mail address for receipt of payment:, only one email per line
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e-mail address for artwork approval: (Same?____)
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By signing this order form, you certify that you are authorized to sign the debit or credit card listed above, that you have read and agree with the terms of service as listed on our web page at http://www.pinable.com/tos.html, that you agree to have the above credit or debit card charged for the merchandise placed by this order, and if applicable, all artwork, cancellation and die fees as explained more fully in the terms of service.
Signature:_________________________________ Printed name:_________________________________ Date:___________________
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