Specialty Rubber Stamps - Fax/Mail Order Form

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, CHEQUE , CASH

SPECIALTY RUBBER STAMPS Co.
4178 Petrolia St. Petrolia, ON. N0N 1R0
Fax: (519) 882 – 1222

ORDER FORM

RUBBER STAMPS

SIZE: LENGTH: ________ x HEIGHT:____________

WOOD _________ or Self-Inking ______________

Make: ______________ Model: _______________

TYPESTYLE# _____________________________

ENGRAVING

SIZE : LENGTH: _______ x HEIGHT:________

COLOUR

SURFACE __________

LETTERS __________

CORNERS

ROUNDED
SQUARE

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PIN BACK ________ or SWIVEL CLIP_________

ADHESIVE BACK ________________________

HOLES___________ LOCATION_____________

COPY

_______________________________________________________________________

PROOF COPY - $3.50 FOR STAMPS, $4.95 FOR ENGRAVING

HEIGHT OF LETTERS

_____________________

SPECIAL NOTES:__________________________________________ APPROX. PRICE__________

CUSTOMER SIGNATURE_________________________________ DATE TODAY_____________

CUSTOMER NAME _____________________________________ DATE REQUIRED___________

ADDRESS_____________________________________________ TEL.#____________________

SAMPLE PROVIDED []

ATTACHED []

EMPLOYEE INIT:____________