Refocus Laser Engraving & Design - Sports Plaque Order Form

Phone: (541) 968-2347

Sports Plaque Order Form

Name:___________________________

Address:_________________________

City:_____________________________

State:___________Zip:______________

Phone:_________________________

Email:______________________________

Shipping Information:

Ship to:________________________________

Address:_______________________________

City:___________________________________

State:______________Zip:_________________

Sports Plaque Information:

Please Print Clearly

Click for larger view

Team Name:

Person's Name:

Text Under Name (if desired):

Additional Text For Plaque ( Up To 4 Lines):

Photo Enclosed: Yes_____ No_____

Special Instructions/Notes:

____________________________________________________________________________

____________________________________________________________________________

________________________________________________________________________________

Sports Graphic Desired:

Baseball: ____	Basketball: ____	Football: ____	Soccer: ____
Other Sport ( Please Specify ): _________________________________________
Custom sizes and designs are available for team photos, coach photos, etc. Ask about quantity discounts for teams or groups of 6 or more!

Quantity	Item Name & Description	Size	Price Each	Total Price
	8” Wide x 10” High Alder	8 x 10	$35.00
	8” Wide x 10” High Appleply	8 x 10	$24.50
Shipping & Handling - $5.00 First Plaque Add $1.00 for each additional plaque
Subtotal
Total

Please Allow 2-3 Weeks for Delivery
Rush Orders Available

Method of Payment:
Check___	Money Order___
Make Payable to Refocus Marketing, LLC

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