Chicago Top Doctors Order Form

If you’d rather fax or mail in your order, you can download a PDF of the order form and fax back to us at 301.774.9664 or mail with your check to ABC Design & Promotion, 18249 Wickham Road Olney, MD 20832. Feel free to call us at 866.570.6900 if you have any questions.

ENTER PROMO CODE HERE:

Recipient Details:

Name of Physician to Appear On Plaque :

Medical Specialty in Magazine:

Please indicate MD or DO:

Contact Person:

Contact Phone:

Contact Organization:

Shipping Address:

Check here if residence: No P.O.Boxes Please

City:

State:

ZIP Code:

E-Mail Address:

Options:

Signature Series (featured in Mailing)
14” x 17” Laminated Plaque: $129.95, Plus $14.95 Shipping

Number of Plaques:

Duplicate Plaques $97.46 (25% Discount), plus $6 Shipping

Please indicate color combinations here if not all the same:

Traditional Series
11" x 14" Laminated Plaque with Engraved Plate: $139.95, Plus $14.95 Shipping
Duplicate Plaques – 25% Discount ($104.96 and $6.00 shipping each)

Elegant Series
12” x 15” Piano Finish Plaque: $189.95, Plus $14.95 Shipping

Number of Plaques:

Duplicate Plaques $127.46, (25% Discount) plus $6 Shipping

Please indicate other color combinations:

Custom Frames
17” x 20” approximate size with double matting and choice of art option: $285.95

Crystal and Lucite
(Please Indicate Quantity)***Take an additional 10% off price of crystal with purchase of a plaque!***

Additional Options:

Graphic File for Web site $50

Additional Counter Cards @ $35 each 1 2 3

500 marketing sheets @ $379

500 Statement Stuffers @ $279

**Graphic web file will be emailed to above address unless otherwise noted.

If only ordering a Web File or a Counter Card please add an additional $50.00 Design Fee.

Additional:

Notes and Comments, (please note here if ordering multiple plaques in more than one color)

Payment Options:

Method of Payment: Visa MasterCard American Express Discover

Credit Card Number:

Expiration Date:

Cardholder’s Name:

Daytime Phone: