Emboss Graphic & Advertising

Company Information:

*Authorized Personel First Name:		M.I.		*Last Name:

*Title:

*E-mail Address: (Your project information and future status will be sent to this address)

*Company Name:

*Street Address:			Website Address

*City:	*State:	*Zip:

*Phone Number:
( )- x (Extension)
*Fax Number:
( )-
Alternative Personel To Contact:
*Name:		*E-mail		*Phone Number:
				( )- x
Payment: We Accept Company or Personal Check.
Payment required in full for postcard and all printing-only projects. Others required 50% deposit and balance in full before shipment. Project will not be started until payment is received.
Payment Type:	Credit Card			Check
Our online credit card processing is coming soon. Please Skip the credit card payment section below.
Credit Card Info:	Visa			Master
	Credit Card #:			Exp. Date	/
Billing Information:
First Name:		M.I.		Last Name:

Street Address: Same as above

City: State: Zip:
For Check: please make it payable to EMBOSS GRAPHIC & ADVERTISING
Please mail check to: 2646 Durfee Ave. Suite 123, El Monte, CA 91732
Enter your password (6 ~ 8 characters):
Confirm your password:
This will be used for FTP upload and project status inquiry.
Brief Survey :
How did you find us? By: YellowPage Internet Search Engine Referral
*Be sure to fill out all required area before submitting.**

Please remember to submit your payment with your order. One of our friendly representatives will contact you when your order arrives. Thank you for your business!