Custom Request Form

Custom Request Form

Want a design that’s just right for you? Fill out the form and let’s chat about what you’re looking for.
Final order approval will be based on the requested design style and delivery location.

A deposit amount will be provided once your custom design has been finalized through our collaboration.
Customer Information:
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Shipping Address

Street Address

Street Address Line 2

CityState

Zip Code
Lamp or Sculpture Type
Style
Additional Information
Signature
Date Signed

MonthDayYear
Date
Should be Empty:

Customer Information: