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Please fill out the form below and submit your information for processing. We will contact you for invoicing.You may also click here to download a copy of the form to email or fax us.
Cost per 8x10 Plaque $35.00                
Flag of Country/State additional $5.00                
Utah Sales Tax for Utah Residents Only 6.25%                  
Shipping & Handling $8.00 for first plaque in the US and $3.00 for each additional plaque.Plaques are shipped USPS Priority Mail                  

Upload your Missionaries Picture by clicking here, please include their full name with the file upload.

Missionary Plaque Order Form


You may request to be invoiced by filling out this form and submitting. We will contact you on the terms of billing. Feel free to give us a call or email us with questions. Innovative Custom Jewelry and Engraving is located at 720 W 100 S, Heber City, Ut. 84032 Phone: 435-654-5661 Fax:435-654-3075 email: tonia@innovativecustomjewelry.com
Ward/Name*
Email*
Phone#
Bill To:*
Delivery Preference*
Ship To:*
Name of Missionary Elder/Sister*
Official Name of Mission*
Mission Starts Month/Year*
Mission Ends Month/Year*
Favorite Scripture Reference*
Flag of Country or State (Additional $5.00)
Flag choice State/Country
Payment Method*
Credit Card#
Credit Card Expiration Date