Contact / Billing Information

First and Last Name:  

Company Name (if applicable):

Business Title: 

Street Address: 

City:  State:  Zip Code: 

Home Phone: Office Phone:

Cell Phone:  Fax:  

Email:

Delivery Information

Day of Delivery: Monday Tuesday Wednesday Thursday Friday Saturday Sunday -select-  Date of Delivery: -month- January February March April May June July August September October November December 1 2 3 4 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2007 2008 2009 2010 2011 2012

Name of facility:

Delivery Street Address:

City:  State: Zip Code:

Facility/Caterer Contact Name:

Phone Number of Facility and/or Caterer:

Special Delivery Information:

Event Information

Type of Event:

Theme of Event:

Color Scheme for Event:

Product Information

Sculpture Desired:

Custom Sculpture Desired:
(please be specific, or request a consultation with James the Ice Sculptor)

Size of Sculpture: -select- Multiple Block Full Block 1/2 Block Other

Available Budget: (for custom design)     Tax Exempt: No  Yes

* Delivery charges may apply for delivery outside of the Seattle, Bellevue, Tacoma area.

* Please submit a Non-Refundable Deposit of $50 to hold the date.

Special Instructions for Sculpture Design. 
Please indicate if you need a consultation to discuss special custom needs for the ice sculpture design. If lettering/names are to be etched in the ice, please indicate that information in the space below:

Comments:

How did you hear about us?: -select- Phone Book Web Site Internet Search Event Referral Returning Customer Other