Design Form

PARTNERS

TIN BOX

front cover artwork

State *

bumper color *

Zip Code *

ELASTIC BAND TO HOLD PAGES IN PLACE *

Both Top and Bottom Bands (recommended)

Bottom Band Only

Top Band Only

No Elastic Bands

BACK cover artwork - adds $10

name on the bumper *

how did you hear about us and what did they say?

Email: *

Last Name *

PENCIL HOLDER *

Yes (recommended)

No

City/County *

Mailing address *

Series Selection *

BASE COLOR FOR YOUR COVER *

special instructions

BOTTOM POCKET ENGRAVING - adds $5

Interior Leather Color Upgrade - Adds $15

First Name *

Phone #

For a gallery of trademark free logos,

visit www.embroiderydesigns.com

border stitch color *

RAIN GUARD - adds $10 *

Yes

No

TOP POCKET ENGRAVING - Adds $5