Safety Glasses Imprinting
Information and Questionnaire
You can have up to 4 separate logo's (Zone 1, Zone 2, Zone 3 and Zone 4)
What style/color would you like to imprint?

How many glasses would you like to imprint? 
Available in multiples of 12 only
 Yes   No  Would you like to add a logo to zone 1?

 0   1   2  If yes then how many colors are in the zone 1 logo?

If yes please describe the logo
 Yes   No  Would you like to add a logo to zone 2?

 0   1   2  If yes then how many colors are in the zone 2 logo?

If yes please describe the logo
 Yes   No  Would you like to add a logo to zone 3?

 0   1   2  If yes then how many colors are in the zone 3 logo?

If yes please describe the logo
 Yes   No  Would you like to add a logo to zone 4?

 0   1   2  If yes then how many colors are in the zone 4 logo?

If yes please describe the logo
If you have any special instructions, please describe here.


Please fill in your contact information, so we can send a quote and order form.
 Name   Required
 Business Name
 Phone Number
 Extension
 Fax Number
 Postal Address 1
 Postal Address 2
 City
 State  
 Zip
 Email   Required


Security Code


Please type the security code you see in the image above into the box below: