Please complete the information requested below. Then, you may either print the form and send it by paper mail, or you may submit the form electronically.
| Name* | |
| Organization | |
| Street Address* | |
| Address (cont.) | |
| City* | |
| State/Province* | |
| Zip/Postal Code* | |
| Country | |
| Work Phone | |
| Home Phone | |
| E-mail* | |
* Required Field
A note on Panel COLORS: The display comes unassembled, so you can order as many panels as you need and place them in the order you need for your school. You can also add more panels later.
Please provide the following ordering information:
| QTY | DESCRIPTION | Price | Sub-Total |
| Standard 3" x 14" Personalized Header | $10.00 | ||
| Certificate Header Frame for 8 1/2 x 11 certificates (certificate not included) | $15.00 | ||
| Black Panel | $3.00 | ||
| Brown Panel | $3.00 | ||
| Red Panel | $3.00 | ||
| Purple Panel | $3.00 | ||
| Green Panel | $3.00 | ||
| Blue Panel | $3.00 | ||
| Orange Panel | $3.00 | ||
| Yellow Panel | $3.00 | ||
| White Panel | $3.00 | ||
| Subtotal | |||
| Promotion Code: | discount | ||
| Subtotal | |||
| California sales tax (if applicable) | |||
| Shipping** (U.S. Rate) | |||
| Total |
| Shipping Method: All displays are shipped by USPS Priority 2-3 day. Shipping costs (For U.S. only). ** International Orders - the shipping calculation above does not apply - please submit this form and we will reply via e-mail with the shipping cost. Note: All orders are shipped without any invoice - so they can be shipped as a gift item. |
| SHIPPING | |
| Check Here if Same as Above | |
| Name | |
| Street Address | |
| Address (cont.) | |
| City | |
| State/Province | |
| Zip/Postal Code | |
| Country |
Enter Your Personalization Information in the Space Below
| Display | First Line | Second Line | Left Graphic Number | Right Graphic Number |
| 1 | ||||
| 2 | ||||
| 3 | ||||
| 4 |
Click Here to Review Available Graphics Selections
Comments are welcome. Please enter in the space provided. If you are ordering more than four displays, please enter the additional personalization information in the box below. Also, if you are ordering more than one display and have an uneven number of panels, let us know below which panels go with which name and we'll be sure to pack them in the right box. Each display is individual boxed.
When you submit this form, your order will be sent to us and you will receive a confirmation page with payment instructions. We accept payments by check or money order. We accept credit cards by PAYPAL.