Custom Embroidery Order Form

 

Website is being updated with new software, so if the form does not go through, please contact me directly at jan@kippahdesign.com
 

Website is being updated with new software, so if the form does not go through,
please contact me directly at jan@kippahdesign.com

* Required Information

* First Name  
* Last Name  
* City, State
* Phone  
* E-mail  

How did you learn about Kippah Design?

 

Just for my own research, would you please tell me what KEY words you used in your search?

 

Please supply more information:
Please contact me by:  

 

All embroidery is custom made.  There are many variables but completing the information below will help me to price your request.  Normal turnaround time is 10 days but can be done on a "rush" basis for an additional fee,  Please supply any other information in the box below.

 Emails received on Friday evening or Saturday will be answered when Shabbat is over.

I am located in North Carolina; if you are in the Midwest or West, please allow for the time difference!

 

Date needed:   
Atarah Blessing:
Fabric:
Finished Length/Width:
Style:
Typeface:
If you choose "specialty" please specify which one in the box at the bottom
Thread Color:
Ends:
Corners (Image Category):

I have lots of designs to choose from, so just let me know what you are interested in!!
 
Finished Size
Hole for Tzitzit:
Kosher Tzitzit:

Please supply additional information.  If you are providing a custom blessing, I need a Bible reference or you can email the wording to me at jan@kippahdesign.com  You can also use the contact form for other questions.

If you need a Hebrew keyboard, you can visit this website to type.  Then highlight the text and paste into a word processing document.  http://www.lexilogos.com/keyboard/hebrew.htm

 

How did you learn about Kippah Design?

 

Choose Payment Method:

Check/Money Order Payable to Jan Gorelick

Mail To:  PO Box 49426, Charlotte, NC 28277

Please be sure to include a printed order form when mailing payment.
I also accept credit card payments through Paypal.  If you wish to use that service, let me know and I'll send an invoice.  There is a 5% fee added.

Please contact me by:

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