Cindy's Creations Custom Order Form
Customer Information

Name: Telephone: e-Mail:

Address: City: State: Zip:


Item Information

Qty: Item Description: Category:

Design Instructions:

Card Msg: Ribbon Msg:

Price Range: Payment: MasterCard Visa We will contact you for Payment Information.


Recipient Information

Name: Telephone: Delivery Date:

Address: City: State: Zip: