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                    WE APOLOGIZE FOR THE INCONVENIENCE. 
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Kustom Keepsakes, Inc. Order Form
Please fill out the information below and mail this form with your photo(s) to:   
Kustom Keepsakes, Inc., 158 Dahlia St., Schenectady, NY  12306 (not a retail location)

CUSTOMER INFORMATION:
Name  

Click here if Shipping to Same Address. Otherwise, please enter shipping address:

Address 1
(NO PO Boxes)
Address 2

Name:

City, State & Zip

Address 1:

E-mail Address

Address 2:
Phone Incl. Area Code

City,St,Zip
If you are unsure of an item's cost, use your back button or click here to go back to Gift Listing Page.
ORDER INFORMATION:

Name of Item(s)

Apparel Size

Adding Text
(Y/N)

Quantity
of Items		 Cost
per Item

Item
Amount

Example: Ceramic Mug n/a No 2 $12.95 $25.90
$ $
$ $
$ $
$ $
$ $

SUBTOTAL

 $

Additional Costs:

wTEXT Charge $2
(per item)

 $
wAdd'tl Image Charge $2
(per item)		 $
wE-Mail Image Charge$1 (per image) $

Total Additional Charges

 $

SUBTOTAL*

 $

TEXT INFORMATION:

Color of Text
Text Font Click here to see EXAMPLES of Font Styles
If you would like a specific font used, let us know and we will try to match it. 

Type the text EXACTLY as you would like it to appear-including placement instructions.
PLEASE NOTE: Text is $2 extra per item (enter amount above)

PHOTO/IMAGE INFORMATION:

Sending via Regular Mail.  Date Sending:
Sending via E-Mail--Click Here File Name of Image:
Located at the following URL address:  http://
We accept .psd, .tif, .jpg, .gif, and .bmp image files ONLY (listed in preferred order)(Please send with an image resolution of at least 300 dpi)

PLEASE CHECK ONE:

the image/photos(s) ARE NOT Copyrighted
the image/photo(s) ARE Copyrighted and a Release Form is being sent with this order. (This form must be printed off, signed and sent to us.)  If you are unsure about copyright laws, please visit our Copyright Page for more information.

SPECIAL INSTRUCTIONS:

(placement of photo(s) and/or text on the item, ship to different address, calendar dates) 
Also if you need this order by a specific date and need "Rush" service, please provide the date and any other important information in the section above and we will do our best to accommodate your needs.

PAYMENT INFORMATION:

Please make  check or money order payable to: Kustom Keepsakes, Inc.
Name as it appears on Credit Card:     
Zip code of Billing Address
Card #Exp. Date: Month

ORDER TOTALS:
 

 

Shipping/Handling Charges
ONLY shipping to US Residents at this time.
Shipping/Handling Charges
(see right for amount)

+

Shipping Method is UPS Ground

$00.00-$10.00 ADD $5.95 per order
$10.01-$20.00 ADD $6.95 per order
$20.01-$50.00 ADD $7.95 per order
$50.01+ ADD $9.95 per order

 Note:  If you were quoted a special large quantity price, enter quoted shipping charges.

Taxable Amount

=
NY Residents ONLY
add 8 % Sales Tax

+

NOTE:  If you are ordering photos only, we can ship them regular mail if you prefer for $2.95 per order (up to 8x12")
Total Amount Charged (US$)

$

Please tell us how you found us!

Which Search Engine? Friend referred you? Another Web Site linked to us? 
Banner Ad? Classified Ad? I-Mall?
 

THANK YOU FOR CHOOSING Kustom Keepsakes, Inc.!

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