PLEASE PRINT OUT THIS PAGE AND MAIL WITH PAYMENT TO:
MICHIGAN LASERMARK     1035 E. STATE ST.   HASTINGS, MICHIGAN   49058
ALLOW 2 WEEKS FOR DELIVERY FROM DATE OF OUR RECEIPT
ORDERING and SHIPPING INFORMATION FOR BRASS PLATES

NAME: ___________________________________ E-MAIL: ______________________ DATE:____________

ADDRESS: ___________________________________________________________________________

CITY: ____________________________________ STATE:________  ZIP CODE:______________

Here's How To Order! Brass plates are marked on one side only. Choose inscription, clipart and font.
PAGE # and CLIPART LETTER Required for proper clip selection.  Attach a description on a seperate sheet if necessary.
Forget which letter goes with which plate?  Go HERE!  
PLATE LETTER:
A= 1  3/4" x 3"  $6.00            B= 1" x 2  1/2"  $5.00 (A & B avail. with or without (2) 1/8" holes centered on each end)
             C= 7/8" x 2  1/2" (Scalloped Corners)  $5.00            D= 1  3/4" x 3" (Luggage Strap)  $7.00

PLATE #1 _____________________________________________________________ (Inscription)
Plate Letter _____    Clipart- Page#_____    Clip Letter_____    Font_______    Holes?(Y/N)_____
                                                                                       PRICE FOR THIS PLATE  $                 _

PLATE #2 _____________________________________________________________ (Inscription)
Plate Letter _____    Clipart- Page#_____    Clip Letter_____    Font_______    Holes? (Y/N)_____
                                                                                       PRICE FOR THIS PLATE  $                _
PLATE #3 _____________________________________________________________ (Inscription)
Plate Letter _____     Clipart- Page#_____     Clip Letter_____     Font_______
                                                                                       PRICE FOR THIS PLATE  $                _

PLATE #4 _____________________________________________________________ (Inscription)
Plate Letter _____     Clipart- Page#_____     Clip Letter_____     Font_______
                                                                                       PRICE FOR THIS PLATE  $                _

                                        TOTAL FOR ALL PLATES BEING ORDERED   $                         _

                                        SHIPPING @ $.50 (FIFTY CENTS) PER PLATE  $                        _
                                                            (NUMBER OF PLATES TIMES FIFTY CENTS EACH)

                                        TOTAL AMOUNT ENCLOSED                              $                        _

        PLEASE NOTIFY ME OF SPECIAL OFFERS AND NEW PRODUCTS FROM MICHIGAN LASERMARK!

THANK YOU FOR YOUR ORDER!