Custom Order Request Form
Ember Hill Creations
Name
*
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Email
Text
Type of Piece
*
Completely Custom Design
Based on a Photo or Reference
Based on an Existing Piece You Saw
Item Type / Size (if known)
(e.g., coaster set, small rectangle sign, bookmark, round wood slice, etc.)
Design Details
*
Describe Your Vision
Upload a Reference Image (optional)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Delivery Method
*
Local Pickup (Columbia, MO)
Shipping ($13 flat rate)
LIMITED Local Pickup (Joplin, MO)
Any special requests or deadlines?
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