PatchPlaques Clocks

Clock Plaque Order Form
PATCH INFORMATION
Enter the description of the patch that you would like made into a clock:
CLOCK PERSONALIZED

Would you like the personalized version of the clock? (Yes / No)
Up to 4 lines of text (28 characters/line max. including punctuation and spaces)
Line 1:
Line 2:
Line 3:
Line 4:

ORDER PRICING
Total of ________ Clock(s) ordered at  $55.95 each = $ _____________ 
Total of ________ Personalized Clock(s) at  $65.95 each = $ _____________ 
Florida Residents add 6.5% sales tax   = $ _____________ 
Shipping and Handling charges are included! Total   = $ _____________
SHIPPING INFORMATION (additional charges apply for coutside continental USA shipments)
Name:
Street Address:
Suite/Apt.:
City: State:           Zip:
Phone (Days): (Eves):
Email address:
BILLING INFORMATION (leave blank if address is the same as shipping address)
Name:
Address:
Suite/Apt.:
City: State:           Zip:
Phone (Days): (Eves):
METHOD OF PAYMENT
   Check or Money Order
  Visa   MasterCard   American Express   Discover
Account #: Expiration:
Signature: Security Code:

 

 

 

 
INSTRUCTIONS
Please print the following form, fill it out, and then send it to us. Be sure to include your patch and payment. Because every order is a Custom Order, we can not ship COD. Colors of the reproduced patch as a finished plaque may vary slightly.
NOTICE
The overall quality of your finished clock is directly related to the condition of the original patch or image that you send us. Try to give us the cleanest item possible. Do not staple, paper clip, or fold the item. Simply place the item within a clean piece of folded white paper and send it to us, along with the completed order form, in any envelope that fits. Your clock will be shipped to you within two weeks.

If your patch is valuable, we recommend that you insure it when you send it to us.

In the event that PatchPlaques.com loses or accidentally destroys your patch, we will replace it when possible or refund the replacement cost, not to exceed twenty five dollars ($25.00), as exclusive remedy.

Please send your patch, this completed order form, and your payment via U.S. Postal Service to:

PatchPlaques.com
P.O. Box 250180
Daytona Beach, FL 32125

If you are sending via UPS, FEDEX or DHL then send your payment to:

PatchPlaques.com
338 Parque Drive, Suite F
Ormond Beach, FL 32174

If you have any questions about your order, contact us at:

info@patchplaques.com 

Phone, toll free, (888) 671-2130

Fax at (386) 676-9117

We sincerely appreciate your business!

© 2002-2007 PatchPlaques.com