Dejay Products (aka Dejaygold)

ORDER FORM
To order plaques please provide all information and fax or email to:

206/784-9109 (fax) or dejaygold@dejaygold.com

 

Name………………………………………..Company……………

 

 

Address……………………………………………………………………………………………………………………………………………………….

 

Tel #…………………………..Email………………………………………

 

Shipping address if different from above………………………………..

………………………………………………………………………………

 

Artist…………………………………….Title……………………………

 

Record Company…………………………….

Record Company Contact if known……………………………………..

 

Name of Recipient………………………………………………………..

(if more than one provide separate list)

 

Circle size; 12x16 14x18 16x20 18x24 20x24 24x36  Other……………

If design layout is selected from the website please indicate  Design #

……………………………………………………………………………

 

For RIAA Certified awards state your connection to the project

……………………………………………………………………….

 

Additional Comments.

PLEASE NOTE: ANY CHANGES MADE TO AN ORDER MUST BE SENT VIA EMAIL. TELEPHONE CONVERSATIONS ARE NOT AN ACCEPTABLE WAY OF MAKING CHANGES UNLESS CONFIRMED BY A FOLLOW-UP EMAIL, BECAUSE WE WILL NOT BE HELD RESPONSIBLE FOR ANY ERRORS MADE.