FREE U.S. SHIPPING - $100 MINIMUM PURCHASE

Excluding Alaska and Hawaii - No Code Required - Not Combinable With Other Discounts

Classic - Floater - Large Order

-- WE ALWAYS EMAIL A PROOF FOR APPROVAL BEFORE MAKING YOUR PLAQUE --

Please provide the requested information, select the desired plaque options, and upload a file with patent numbers. The file can be in just about any format, e.g., pdf, doc, docx, xls, csv.

After we receive your submission, we will contact you regarding billing/shipping information.

If you have any questions, please call us toll free at 1-888-865-3112 or Email IPlax .

--- IMAGE WILL CHANGE WITH OPTION SELECTIONS ---

($110 + options)

This order form is for Large Orders. If you are ordering fewer than 5 plaques, please use our Regular Order Form

Plaque Style:
Your Name:

Your Telephone Number:
Your Email Address:
Select Plaque Size:
Select Plaque Base:
Select Trim Plate:
Select Plate Color:
Inventor(s):
Include Assignee?
<Upload Patent Numbers: