Dejay Products (aka Dejaygold)

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

dejaygold@dejaygold.com

or call

253-212-2690

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.