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1
Commissioned Pieces
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2
Please Read Before Booking
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Please allow 4-6 weeks for your custom piece to be completed. Handmade with deep care and creative intention. I can only complete 2-3 biweekly at this time. A
non-refundable deposit of $200 (16x20) or $85 (10x20) cash only
required to secure your order. This goes toward the final cost of your piece and allows me to begin your design process. You’ll receive a confirmation message and payment instructions after I review your form.
I understand that my piece may take 4-6 weeks to complete and that a non-refundable cash deposit is required before my order is confirmed and creation begins.
Rush order (TBD)
Other
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3
Pick a Date
*
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Please pick a date to meet for the deposit and any personal items that will be added. I will send you the location by your preferred contact. When your piece is complete you will pay the end balance
cash only
as well. Note: I will have a cash pen for checking bills whether I know you or not. Please do not be offended because I’m letting you know now. I’m not saying anything about you. I’m protecting myself thank you for understanding. Mon-Fri (9:00a-12:00p). Sat & Sun (Closed)
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4
Are you a new or existing customer?
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I am a new customer
I am an existing customer
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5
Name
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Please enter your first and last name for identification.
Ex. Remell Jackson
First Name
Last Name
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6
Phone Number
*
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Provide your phone number so I can contact you if needed. Ex.
(
123)
456-7890
Area Code
Phone Number
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7
Preferred Contact Method?
*
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Phone (call)
Phone (text)
Email
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8
Email
*
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Enter your email address to receive updates and confirmation. Ex. remell@email.com
example@example.com
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9
Date of Birth & End of Life
*
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MM/DD/YYYY-MM/DD/YYY
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10
Canvas
*
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Size and price. Please note all canvases come with crushed glass designs. 10x20 canvases come with 1 picture and 1 short quote, poem, or scripture. If you don't want a quote a max of 2 pictures is allowed. 16x20 canvases come with 2 pictures and 1 short quote, poem, or scripture. If you do not want a poem a max of 4 pictures is allowed.
16x20 ($400) 2 pictures and 1 quote, poem, or scripture
16x20 ($400) pictures only (max 4)
10x20($160) 1 picture and 1 short quote, poems, or scripture
10x20 ($160) pictures only (max 2)
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11
Pictures of Loved One
*
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Add the pictures you would like on the canvas here..
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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12
Poem, Scripture, Quotes
*
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Please share the poem, scripture, or quote you’d like included on your piece. If you need help simply note “Suggest/channel one for me.” This is a space where you can be as personal or discreet about your loved one. Just a little information about who they were will help me find something that matches their essence. Everything will be run by you first during the process to make sure it’s a perfect fit.
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quote
Created with Sketch.
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13
What color(s) would you like to add to your canvas?
.
*
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Please specify your preferred colors or color scheme for the piece. If you have particular tones, shades, or combinations in mind, feel free to mention them!)
Note: Keep in mind that fluid art involves mixing paints with various additives (like pouring medium or other materials) that can sometimes subtly alter the final color or appearance. I will do my best to match your vision while embracing the natural flow and unique qualities of fluid art.
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quote
Created with Sketch.
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14
Embellishments
*
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Each piece comes with crushed glass and acrylic paint pen freestyle design. Note: Crystals should be small, some medium sizes are accepted. Crystals are purchased by you. You’re welcome to bring them to me, or if it’s more convenient, I may be able pick them up for you—just let me know, and we can coordinate based on my schedule! Limit one for flakes.
Gold Flakes
Silver Flakes
Rose Gold Flakes
Crystals (rose quartz, lapis lazuli, onyx etc.) ~optional~
Personal Items ~optional~
Dried Flowers
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15
Crystals or Personal Item Add-on (Optional)
If you'd like crystals or personal items added, let me know..
Skip if not
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16
Upload Crystal or Personal Item Pictures
This is
NOT
optional if you are adding crystals or personal items please upload here. Add the picture of the crystals or personal items you want added to the canvas. I will let you know via email if they meet the size requirements.
Skip if not
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
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17
Deposit Due 💵 (cash only)
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This is the amount due on the day you selected at the top of the form on the calendar. Please cash only for the deposit and remaining balance. Thank you
16x20 ($400) Remaining balance: $150
10x20 ($160) Remaining balance: $75
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18
Commissioned Piece
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