Etched Glassware Order Form This form will submit your enquiry or order directly to Northwest Creations. Alternatively you may print this form, complete it and mail to Northwest Creations, 13106 S.E. 234th Street, Kent, WA 98031, U.S.A.

Customer Details (name and address must be as on credit card) Name Email Address Telephone Full Street Address including Zip / Postal Code and Country Shipping Details (if different from Customer Details above) Name Telephone Full Street Address including Zip / Postal Code and Country OrderDetails Quantity Item Coat(s) of arms to be etched *** No Item Selected ($0) *** Cut 24% Lead Crystal Decanter + 6 glasses $299 Cut 24% Lead Crystal Decanter + 4 glasses $225 Cut 24% Lead Crystal Decanter + 2 glasses $165 Cut 24% Lead Crystal Decanter $115 Six 24% Lead Cut Crystal Glasses $190 Four 24% Lead Cut Crystal Glasses $135 Two 24% Lead Cut Crystal Glasses $80 Single 24% Lead Cut Crystal Glass $50 Single 25 Ounce Beer Mug $48 Pair 25 Ounce Beer Mugs $82 Set of Six 25 Ounce Beer Mugs $205 Single 20 Ounce Beer Mug $45 Pair 20 Ounce Beer Mugs $80 Set of Six 20 Ounce Beer Mugs $195 Single 16 Ounce Beer Mug $44 Pair 16 Ounce Beer Mugs $75 Set of Six 16 Ounce Beer Mugs $185 Single 24 Ounce Blue Beer Mug - Clear Bottom and Handle $54 Pair 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $95 Set of Six 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $245 Single 20 Ounce Pilsner Glass $39 Pair 20 Ounce Pilsner Glasses $64 Set of Six 20 Ounce Pilsner Glasses $155 Single 16 oz. large coffee mug $40 Pair 16 oz. large coffee mugs $66 Set of Six 16 oz. large coffee mugs $160 Single 12 ounce Cobalt Blue Coffee Cup $40 Pair 12 ounce Cobalt Blue Coffee Cups $66 Set of Six 12 ounce Cobalt Blue Coffee Cups $160 Single 10 ounce Coffee Cup $38 Pair 10 ounce Coffee Cups $62 Set of Six 10 ounce Coffee Cups $145 Single Irish Coffee Mug - Clear $40 Pair Irish Coffee Mugs - Clear $66 Set of Six Irish Coffee Mugs - Clear $160 Single Irish Coffee Mug - Blue $40 Pair Irish Coffee Mugs - Blue $66 Set of Six Irish Coffee Mugs - Blue $160 Single 5 Ounce Bristol Bar Shot Glass $39 Pair 5 Ounce Bristol Bar Shot Glasses $64 Set of Six 5 Ounce Bristol Bar Shot Glasses $155 Single Regular Round Whiskey Glass $38 Pair Regular Round Whiskey Glasses $62 Set of Six Regular Round Whiskey Glasses $145 Single Large Square Whiskey Glass $39 Pair Large Square Whiskey Glasses $64 Set of Six Large Square Whiskey Glasses $155 Single Champagne Flute $39 Pair Champagne Flutes $64 Set of Six Champagne Flutes $155 His and Hers Champagne Flutes $70 His and Hers Champagne Flutes + etched bottle of champagne $99 Single Stemmed Wine Glass $39 Pair Stemmed Wine Glasses $64 Set of Six Stemmed Wine Glasses $155 His and Hers Stemmed Wine Glass $70 His and Hers Stemmed Wine Glass + etched bottle of wine $99 *** No Item Selected ($0) *** Cut 24% Lead Crystal Decanter + 6 glasses $299 Cut 24% Lead Crystal Decanter + 4 glasses $225 Cut 24% Lead Crystal Decanter + 2 glasses $165 Cut 24% Lead Crystal Decanter $115 Six 24% Lead Cut Crystal Glasses $190 Four 24% Lead Cut Crystal Glasses $135 Two 24% Lead Cut Crystal Glasses $80 Single 24% Lead Cut Crystal Glass $50 Single 25 Ounce Beer Mug $48 Pair 25 Ounce Beer Mugs $82 Set of Six 25 Ounce Beer Mugs $205 Single 20 Ounce Beer Mug $45 Pair 20 Ounce Beer Mugs $80 Set of Six 20 Ounce Beer Mugs $195 Single 16 Ounce Beer Mug $44 Pair 16 Ounce Beer Mugs $75 Set of Six 16 Ounce Beer Mugs $185 Single 24 Ounce Blue Beer Mug - Clear Bottom and Handle $54 Pair 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $95 Set of Six 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $245 Single 20 Ounce Pilsner Glass $39 Pair 20 Ounce Pilsner Glasses $64 Set of Six 20 Ounce Pilsner Glasses $155 Single 16 oz. large coffee mug $40 Pair 16 oz. large coffee mugs $66 Set of Six 16 oz. large coffee mugs $160 Single 12 ounce Cobalt Blue Coffee Cup $40 Pair 12 ounce Cobalt Blue Coffee Cups $66 Set of Six 12 ounce Cobalt Blue Coffee Cups $160 Single 10 ounce Coffee Cup $38 Pair 10 ounce Coffee Cups $62 Set of Six 10 ounce Coffee Cups $145 Single Irish Coffee Mug - Clear $40 Pair Irish Coffee Mugs - Clear $66 Set of Six Irish Coffee Mugs - Clear $160 Single Irish Coffee Mug - Blue $40 Pair Irish Coffee Mugs - Blue $66 Set of Six Irish Coffee Mugs - Blue $160 Single 5 Ounce Bristol Bar Shot Glass $39 Pair 5 Ounce Bristol Bar Shot Glasses $64 Set of Six 5 Ounce Bristol Bar Shot Glasses $155 Single Regular Round Whiskey Glass $38 Pair Regular Round Whiskey Glasses $62 Set of Six Regular Round Whiskey Glasses $145 Single Large Square Whiskey Glass $39 Pair Large Square Whiskey Glasses $64 Set of Six Large Square Whiskey Glasses $155 Single Champagne Flute $39 Pair Champagne Flutes $64 Set of Six Champagne Flutes $155 His and Hers Champagne Flutes $70 His and Hers Champagne Flutes + etched bottle of champagne $99 Single Stemmed Wine Glass $39 Pair Stemmed Wine Glasses $64 Set of Six Stemmed Wine Glasses $155 His and Hers Stemmed Wine Glass $70 His and Hers Stemmed Wine Glass + etched bottle of wine $99 *** No Item Selected ($0) *** Cut 24% Lead Crystal Decanter + 6 glasses $299 Cut 24% Lead Crystal Decanter + 4 glasses $225 Cut 24% Lead Crystal Decanter + 2 glasses $165 Cut 24% Lead Crystal Decanter $115 Six 24% Lead Cut Crystal Glasses $190 Four 24% Lead Cut Crystal Glasses $135 Two 24% Lead Cut Crystal Glasses $80 Single 24% Lead Cut Crystal Glass $50 Single 25 Ounce Beer Mug $48 Pair 25 Ounce Beer Mugs $82 Set of Six 25 Ounce Beer Mugs $205 Single 20 Ounce Beer Mug $45 Pair 20 Ounce Beer Mugs $80 Set of Six 20 Ounce Beer Mugs $195 Single 16 Ounce Beer Mug $44 Pair 16 Ounce Beer Mugs $75 Set of Six 16 Ounce Beer Mugs $185 Single 24 Ounce Blue Beer Mug - Clear Bottom and Handle $54 Pair 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $95 Set of Six 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $245 Single 20 Ounce Pilsner Glass $39 Pair 20 Ounce Pilsner Glasses $64 Set of Six 20 Ounce Pilsner Glasses $155 Single 16 oz. large coffee mug $40 Pair 16 oz. large coffee mugs $66 Set of Six 16 oz. large coffee mugs $160 Single 12 ounce Cobalt Blue Coffee Cup $40 Pair 12 ounce Cobalt Blue Coffee Cups $66 Set of Six 12 ounce Cobalt Blue Coffee Cups $160 Single 10 ounce Coffee Cup $38 Pair 10 ounce Coffee Cups $62 Set of Six 10 ounce Coffee Cups $145 Single Irish Coffee Mug - Clear $40 Pair Irish Coffee Mugs - Clear $66 Set of Six Irish Coffee Mugs - Clear $160 Single Irish Coffee Mug - Blue $40 Pair Irish Coffee Mugs - Blue $66 Set of Six Irish Coffee Mugs - Blue $160 Single 5 Ounce Bristol Bar Shot Glass $39 Pair 5 Ounce Bristol Bar Shot Glasses $64 Set of Six 5 Ounce Bristol Bar Shot Glasses $155 Single Regular Round Whiskey Glass $38 Pair Regular Round Whiskey Glasses $62 Set of Six Regular Round Whiskey Glasses $145 Single Large Square Whiskey Glass $39 Pair Large Square Whiskey Glasses $64 Set of Six Large Square Whiskey Glasses $155 Single Champagne Flute $39 Pair Champagne Flutes $64 Set of Six Champagne Flutes $155 His and Hers Champagne Flutes $70 His and Hers Champagne Flutes + etched bottle of champagne $99 Single Stemmed Wine Glass $39 Pair Stemmed Wine Glasses $64 Set of Six Stemmed Wine Glasses $155 His and Hers Stemmed Wine Glass $70 His and Hers Stemmed Wine Glass + etched bottle of wine $99 *** No Item Selected ($0) *** Cut 24% Lead Crystal Decanter + 6 glasses $299 Cut 24% Lead Crystal Decanter + 4 glasses $225 Cut 24% Lead Crystal Decanter + 2 glasses $165 Cut 24% Lead Crystal Decanter $115 Six 24% Lead Cut Crystal Glasses $190 Four 24% Lead Cut Crystal Glasses $135 Two 24% Lead Cut Crystal Glasses $80 Single 24% Lead Cut Crystal Glass $50 Single 25 Ounce Beer Mug $48 Pair 25 Ounce Beer Mugs $82 Set of Six 25 Ounce Beer Mugs $205 Single 20 Ounce Beer Mug $45 Pair 20 Ounce Beer Mugs $80 Set of Six 20 Ounce Beer Mugs $195 Single 16 Ounce Beer Mug $44 Pair 16 Ounce Beer Mugs $75 Set of Six 16 Ounce Beer Mugs $185 Single 24 Ounce Blue Beer Mug - Clear Bottom and Handle $54 Pair 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $95 Set of Six 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $245 Single 20 Ounce Pilsner Glass $39 Pair 20 Ounce Pilsner Glasses $64 Set of Six 20 Ounce Pilsner Glasses $155 Single 16 oz. large coffee mug $40 Pair 16 oz. large coffee mugs $66 Set of Six 16 oz. large coffee mugs $160 Single 12 ounce Cobalt Blue Coffee Cup $40 Pair 12 ounce Cobalt Blue Coffee Cups $66 Set of Six 12 ounce Cobalt Blue Coffee Cups $160 Single 10 ounce Coffee Cup $38 Pair 10 ounce Coffee Cups $62 Set of Six 10 ounce Coffee Cups $145 Single Irish Coffee Mug - Clear $40 Pair Irish Coffee Mugs - Clear $66 Set of Six Irish Coffee Mugs - Clear $160 Single Irish Coffee Mug - Blue $40 Pair Irish Coffee Mugs - Blue $66 Set of Six Irish Coffee Mugs - Blue $160 Single 5 Ounce Bristol Bar Shot Glass $39 Pair 5 Ounce Bristol Bar Shot Glasses $64 Set of Six 5 Ounce Bristol Bar Shot Glasses $155 Single Regular Round Whiskey Glass $38 Pair Regular Round Whiskey Glasses $62 Set of Six Regular Round Whiskey Glasses $145 Single Large Square Whiskey Glass $39 Pair Large Square Whiskey Glasses $64 Set of Six Large Square Whiskey Glasses $155 Single Champagne Flute $39 Pair Champagne Flutes $64 Set of Six Champagne Flutes $155 His and Hers Champagne Flutes $70 His and Hers Champagne Flutes + etched bottle of champagne $99 Single Stemmed Wine Glass $39 Pair Stemmed Wine Glasses $64 Set of Six Stemmed Wine Glasses $155 His and Hers Stemmed Wine Glass $70 His and Hers Stemmed Wine Glass + etched bottle of wine $99 *** No Item Selected ($0) *** Cut 24% Lead Crystal Decanter + 6 glasses $299 Cut 24% Lead Crystal Decanter + 4 glasses $225 Cut 24% Lead Crystal Decanter + 2 glasses $165 Cut 24% Lead Crystal Decanter $115 Six 24% Lead Cut Crystal Glasses $190 Four 24% Lead Cut Crystal Glasses $135 Two 24% Lead Cut Crystal Glasses $80 Single 24% Lead Cut Crystal Glass $50 Single 25 Ounce Beer Mug $48 Pair 25 Ounce Beer Mugs $82 Set of Six 25 Ounce Beer Mugs $205 Single 20 Ounce Beer Mug $45 Pair 20 Ounce Beer Mugs $80 Set of Six 20 Ounce Beer Mugs $195 Single 16 Ounce Beer Mug $44 Pair 16 Ounce Beer Mugs $75 Set of Six 16 Ounce Beer Mugs $185 Single 24 Ounce Blue Beer Mug - Clear Bottom and Handle $54 Pair 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $95 Set of Six 24 Ounce Blue Beer Mugs - Clear Bottom and Handles $245 Single 20 Ounce Pilsner Glass $39 Pair 20 Ounce Pilsner Glasses $64 Set of Six 20 Ounce Pilsner Glasses $155 Single 16 oz. large coffee mug $40 Pair 16 oz. large coffee mugs $66 Set of Six 16 oz. large coffee mugs $160 Single 12 ounce Cobalt Blue Coffee Cup $40 Pair 12 ounce Cobalt Blue Coffee Cups $66 Set of Six 12 ounce Cobalt Blue Coffee Cups $160 Single 10 ounce Coffee Cup $38 Pair 10 ounce Coffee Cups $62 Set of Six 10 ounce Coffee Cups $145 Single Irish Coffee Mug - Clear $40 Pair Irish Coffee Mugs - Clear $66 Set of Six Irish Coffee Mugs - Clear $160 Single Irish Coffee Mug - Blue $40 Pair Irish Coffee Mugs - Blue $66 Set of Six Irish Coffee Mugs - Blue $160 Single 5 Ounce Bristol Bar Shot Glass $39 Pair 5 Ounce Bristol Bar Shot Glasses $64 Set of Six 5 Ounce Bristol Bar Shot Glasses $155 Single Regular Round Whiskey Glass $38 Pair Regular Round Whiskey Glasses $62 Set of Six Regular Round Whiskey Glasses $145 Single Large Square Whiskey Glass $39 Pair Large Square Whiskey Glasses $64 Set of Six Large Square Whiskey Glasses $155 Single Champagne Flute $39 Pair Champagne Flutes $64 Set of Six Champagne Flutes $155 His and Hers Champagne Flutes $70 His and Hers Champagne Flutes + etched bottle of champagne $99 Single Stemmed Wine Glass $39 Pair Stemmed Wine Glasses $64 Set of Six Stemmed Wine Glasses $155 His and Hers Stemmed Wine Glass $70 His and Hers Stemmed Wine Glass + etched bottle of wine $99 Please note that all prices are exclusive of shipping and packaging which will be charged strictly at cost Credit Card Information (if ordering by mail you may also pay by Cheque / Check, Money Order, Money Check, Postal Order. These should be made payable to Northwest Creations.) Card Type *** Select One ***VisaMastercardNovus/DiscoverWill phone with details We can only accept the listed credit cards - sorry. Card Number If you are uncomfortable supplying your credit card information over the Internet, you may leave this information blank and phone in the details to 1-253-631-5594 3 Digit Security Code You can usually find this number printed on the reverse of your card on the signature strip. Expiration Month010203040506070809101112Year20052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820302028 Cardholder As printed on card Any Additional Information / Instructions you want to supply When form is complete click ONCE only. Processing may take a moment or two - please be patient. Thank you for your business. The Araltas Team. Remember that these items are individually handcrafted. Both the coat of arms design and the etching are executed with tender loving care. This takes time, so please allow up to 28 days for delivery. If sending form by mail please sign and date Signed:__________________________________________ Date________________________

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