Shipping and Contact Information
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| First Name |
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| Last Name |
*
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| Address |
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| Address 2 |
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| City |
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| State |
[please use 2-digit abbreviation] * |
| Zip Code |
*
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| Telephone |
* PLEASE check for accuracy.
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| Cell Phone or Alt Phone |
* PLEASE check for accuracy.
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| FAX |
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| Email |
*
[Your email address will be kept private and will not be sold or redistributed.]
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| Best Day-Time to Reach You |
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[Omega Engraving operation hours are Monday-Friday in the Pacific Standard Time zone. |
Badge Order Information
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| Badge Surface Color |
* [Please tell us what color you want the badge surface for badges on this order form page to be.]
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| Badge Lettering Color |
* [Please tell us what color you want the badge lettering for badges on this order form page to be.]
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| Sublimated Badges |
[If you are wanting Sublimated Multi-colored Badges then check this box and call us at 541.476.1789 before placing your order.]
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| Badge Other Description |
[Please tell us if you want something additional and describe it.]
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KoC Clients: the standard KoC badge comes with the basic round disc emblem. If you wish to purchase an upgraded emblem for "KoC Insurance" or for the "KoC Raised Cut to Shape Emblem" then fill in your choice below. You can view these emblem choices on our pricing page.
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| KoC Upgrade Emblem |
* [for KoC customers only - disregard if not] (click to review KoC emblems on our simple pricing page)
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| Additional Comments or Instructions... |
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Order Payment Information
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| Choose A Payment Method |
To ensure your security and timely accurate order processing we accept payments via credit card or mail-in. Please remember proper postage will be added to all orders. Orders of 20 or more badges receive a 10% discount. |
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| Submitting CC Info With Order |
*YOUR CREDIT CARD WILL BE CHARGED UPON RECEIPT OF ORDER. PLEASE ALLOW 2 TO 3 WEEKS FOR DELIVERY AFTER YOUR ORDER IS PLACED.
IF YOU NEED YOUR ORDER SOONER PLEASE CALL OR CONTACT US. |
| CC Number (16 digits) |
Each box accepts 4 digits of your credit card number.
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| CC Expiration |
Enter your credit card expiration date as it appears on your card.
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| CC Security Code |
Enter your credit card 3 or 4 digit security code [CSC,CVC,CVD,CVV,CVVC,SPC or V-code] as it appears on your card.
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| CC Billing Information |
Enter your NAME EXACTLY as it appears on your credit card.
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Enter your credit card BILLING ADDRESS as it appears on your credit card statement.
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Enter your billing address CITY as it appears on your credit card statement.
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Enter your billing address STATE as it appears on your credit card statement.
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Enter your billing address ZIP CODE as it appears on your credit card statement.
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Enter your billing PHONE number as it appears on your credit card statement.
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*READ THE FOLLOWING BEFORE CLICKING "SUBMIT ORDER". You will receive an email confirmation of your submitted order at the email address you provided. Please note that a Shipping and Handling fee will be added to the cost of each order.
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| Consent |
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Your privacy and security is important to us. You will be contacted directly and discreetly regarding order payment.
By checking this consent box and clicking the "Submit Form" button I hereby request an order submission to Omega Engraving and consent to having them, their agent(s) or representative(s) contact me via telephone, FAX, email and/or cell
phone as needed to facilitate this process. I also understand that a separate Shipping & Handling fee will be added to the cost of my order.
OMEGA ENGRAVING WILL NOT BE RESPONSIBLE FOR MISSPELLED NAMES ON ORDERS. ANY BADGE OMEGA ENGRAVING ENGRAVES INCORRECTLY WILL BE MADE OVER AT NO ADDITIONAL COST. A $25.00 SERVICE CHARGE WILL BE ASSESSED FOR RETURNED CHECKS. I WILL ALLOW 2 TO 3 WEEKS DELIVERY AFTER CORRECT, AND CONFIRMED, PLACEMENT OF MY ORDER.
If I am paying by credit card then I am authorizing Omega Engraving to call me at the number provided to obtain my payment information. I understand that Omega Engraving, for my security, does not prefer to receive the credit card information via email or any other insecure method, or even by online submission but makes this option available for my convenience/preference.
I have read, or have had read to me, the above consent. I have also had an opportunity to ask questions about its content, and by giving consent and clicking "submit order", I agree to the above procedures.
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