printable Order form

On-line Order Form | Order Form Instructions

Select the specification of your plaque:

Shape:   Motif:
         
Size:   Layout - lettering and/or numbers
         
Orientation:
(Ovals only)		   1. Top:
         
Glaze Colour:   2. Middle:
         
Letter/No/Motif Colour:   3. Bottom:
         
Click on a plaque shape for help with lettering/number/motif configurations: Click for Oval Configuration Help Click for Round Configuration Help Click for Rectangle Configuration Help Click for Square Configuration Help
 
Oval
 Round Rectangle Square
PURCHASER DETAILS PAYMENT DETAILS
Name:

I wish to pay by: Cheque (payable to HJ Phillips)

Address: Visa MasterCard Maestro Switch
  Name Printed
on Card
  Card No
  Start Date MM/YY
Post Code: Expiry Date MM/YY
Phone: Issue No (If Applicable)
Email   CVV
Security No
   
Signature:
:  
Date: DD/MM/YYYY

 

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