Embroidered Belt Order Form

This form is for ordering Embroidered Belts only.

Please provide the following contact information:

Name:

Organization:

Street Address:

(Con't)

City:

State/Province:

Zip/Postal Code:

Country:

Daytime Phone:

FAX:

Email:

Please provide your account information:
If you do not have a customer ID# leave blank.

belt sites

Enter in the space below what you would like embroidered on the belt end position "A"

Enter in the space below what you would like embroidered on the belt end position "B"

What language would you like for position "A"

What language would you like for position "B"

Please Specify if you want your text going vertically up and down the belt
or horizontally across the belt.

Which Belt would you like embroidered? What Size?

Note: When choosing size consider the length so your embroidery does not end up in the knot.

What Thread Color would you like your belt embroidered with?
If Other Please Specify

Labor set-up Charge (per belt)

$25 for one tip, $30 for two tips

Number of sewn Letters or Characters _______ X $1.00

Number of Stripes _______ X $0.50

Cost of the belt (from our price list)

Translation Fee $5.00 (per belt)

Subtotal

Washington State Residents add 8.6% Sales Tax

Inside the U.S., Shipping and Handling is $7.50 (per belt)
Outside U.S. continent, please email us for shipping quote.

TOTAL

Please include any comments that will help us make your belt exactly the way you want.
For example, if you have characters translation ready, you can attach your graphic file with your e-mail, or if you would like translation into Japanese or Chinese and whether you want all or partially translated.

Payment Information
Credit Card
Credit Card Number
CC Expiration Date
Name on Credit Card

For further assistance please call our offices at 1-800-535-7573.

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