BALLOON IMPRINT ORDER FORM - RETAIL 
Please print and fax to 626-291-5182 or mail to the address below.

QUANTITY _________ SIZE_______ INK COLOR(S)________________________

COLOR(S) OF BALLOONS___________________________ or ASSORTED________

DATE YOU MUST HAVE BALLOONS (by close of business)_________________
(For next business day shipping, orders must be completed by 3PM ET)

TYPESTYLE_________________ LOGO OR ARTWORK_________________________
(Emailed artwork must be line art black on white only. No gray scale or shadeing.

BALLOON ACCESSORIES: Seals/Valves/Straws/Saucers ___________________

Ribbon_____________________________________________________________

SHIP-TO
ADDRESS:___________________________________________________________

___________________________________________________________________

___________________________________________________________________

__________________________________________ZIP CODE ________________

DELIVERY ADDRESS PHONE NUMBER #(______ )___________________________

CREDIT CARD* 
NUMBER #___________________________________________EX DATE_________

NAME ON* 
CREDIT CARD________________________________________________________

CREDIT CARD*
BILLING ADDRESS____________________________________________________
(if different from 
ship-to)
_____________________________________________ZIP___________________

HOME PHONE NUMBER #(_______)_______________________________________

WORK PHONE NUMBER #(_______)_______________________________________

FAX PHONE NUMBER #(________)_______________________________________

YOUR EMAIL:______________________@_________________________________

SPELLING AND LAYOUT OF IMPRINT: One Side Imprint_____ Two Side_____
(4 LINES OF TEXT / 15 CHARACTERS PER LINE MAXIMUM RECOMMENDED)

LINE 1
___________________________________________________________________

LINE 2
___________________________________________________________________

LINE 3
___________________________________________________________________

LINE 4
___________________________________________________________________

IF WE ARE USING YOUR SHIPPING ACCOUNT TO SHIP, PLEASE 

PROVIDE THAT ACCOUNT #:____________________________________________

*All imprint orders must be pre-paid.

Mailing Address & Customer Service Information:

Palitex Balloon Mfg. Inc.
410 Agostino Rd.
San gabriel, CA 91776

Customer Service Hours: 8:30AM-4PM PST, MONDAY -FRIDAY: 

PHONE: 626-291-5180 or 800-347-2843
FAX: 626-291-5182

 


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