Pottery House Signs | Printable Order Form

Shape:

Motif:

Size:

Layout - lettering and/or numbers

Orientation:
(Ovals only)

1. Top:

Glaze Colour:

2. Middle:

Letter/No/Motif Colour:

3. Bottom:

Click on a plaque shape for help with lettering/number/motif configurations:
	Oval	Round	Rectangle	Square

PURCHASER DETAILS		PAYMENT DETAILS
Name:		I wish to pay by: Cheque (payable to HJ Phillips)
Address:		Visa MasterCard Maestro Switch
		Name Printed on Card
		Card No
		Start Date MM/YY
Post Code:		Expiry Date MM/YY
Phone:		Issue No (If Applicable)
Email		CVV Security No
		Signature:
:		Date: DD/MM/YYYY