Statuette Order Form

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IMPACT DOCS Statuette Order Form

Fields marked with an * are required

Complete this section for addresses in the United States

Complete this section for international addresses

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INSTRUCTIONS

The words "Impact DOCS Winner" will be on the top lineĀ (line #1) of your award .

Your level of award (Award of Merit, Award of Excellence, or Best of Show) will be on line #2 of the statuette.

IN ADDITION to the first two lines (above) you haveĀ  an another six (6) lines.

You do NOT need to use all six lines.

NO MORE than 24 characters (including spaces) per line.

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Statuette # 1

Statuette #2

Statuette #3

Statuette #4

Statuette #5

Statuette #6

Statuette #7

Statuette #8

Order Totals

When you click the "submit" button - you will be taken to the secure PayPal website for payment.

You can pay with a PayPal account or a credit card.

When your transaction is complete - you will automatically be brought back to this page.