Art Empowerment Mural Request Form

Custom Item Inquiry Form

Thank you for your interest in a having a customized item made. We take pride in providing unique statement pieces. Please fill out this form to start the approval process.
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Instagram or Facebook handle *
PRICING: Pricing varies. Pricing increases or decreases based on size, intricacy of details, and the type of item. FINAL PRICE WILL BE DETERMINED CONSIDERING the design requests, the surface, materials etc.

TURNAROUND TIME: . there is a custom turnaround time of 2-3 weeks. If you need your item before then, a rush fee will apply
Design Requests

To help execute your vision, please answer the questions below with very specific details. Please include reference photos as examples to help us understand and to use as inspiration. Please note that we DO NOT create cartoon characters, licensed logos, or personal logos on items.
Please indicate what item you would like customized. Most items MUST BE MAILED IN. Some kids items can be provided. This is only on a case by case basis. For any item provided, that cost will be added to the custom design fee.*

A. Adult or teen JacketB. Little Kid/ toddler jacketC. JeansD. HandbagE. Shoe/ BootF. HatE. Basketball
What size is your item?*
Please share more details for your choice below. MUST INCLUDE 1. Any specific colors 2. Affirmations or quotes 3. Patterns or prints that you would like (if any) 4. Things you DO NOT LIKE. 5. Any other things you would like incorporated. *
Please upload a drawing/ sketch to show the placement of your requests. YOU DO NOT HAVE TO BE AN ARTIST. Please do to the best of your ability. This is very helpful in executing your vision.

Browse Files

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Please upload pictures as examples and pictures that can used as a reference and inspiration for your request. *

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Please upload a picture of your item. *

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Please add any other details here
Next Steps

Upon submission of the form please allow our team time to review. Please allow 24- 48 hours for a response.
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Custom Item Inquiry Form

Design Requests

Next Steps