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Ordering by Mail/Fax

Mail Order Form-Please fill in the order form completely.  Then print the order form and mail it with your picture or disk and your method of payment to: Halsey, Inc, Route 706, P.O. Box 399, Montrose, PA 18801-0399, or you may fax your order to 570-278-3606 and email your digital photo.  Please make sure you put your name on the back of the photo, being careful not to press to hard as you may damage your photo.  Your product should typically be shipped in less than 2 weeks.

Ordered By: Ship To:
Name Name
Address Address
City City
State               Zip State               Zip
Phone: Day Phone: Day
Phone: Evening Phone: Evening
Email Address Email Address


Item Number

Name of Item

Price Each


CPP-10 Custom Picture Plate $15.95
CPP-10B Custom Picture Plate with Border

Black  Purple  Blue  Red Green

CPP-10HB Custom Picture Plate with Heart Border $17.45
CPP-I10 Imprinting Information: Limit 3 Lines, 20 Characters/Line

GFT-CPPW Custom Picture Picture with Walnut Finish Frame Gift Certificate $28.95
GFT-CPPO Custom Picture Plate with Oak Frame Gift Certificate $33.95
OAK-10 Round Oak Frame $17.99
WAL-10 Round Walnut Finish Frame $12.99
48-0030 Brass Plate Wire $1.25
49-0130 Brass Plate Wall Hanger $1.75
40-0310 Wrought Iron Plate Hanger-Triangle Black $2.50
40-0310G Wrought Iron Plate Hanger-Triangle Gold $2.50
40-0400 Wrought Iron Plate Hanger-Rectangle Black $3.50
40-0400G Wrought Iron Plate Hanger-Rectangle Gold $3.50
40-0315G Ornate Brass Plate Holder-Top Piece $4.50
40-0325G Ornate Brass Plate Holder-Extension $4.50
49-0240 Stretcher Plate Hanger $1.50
227-PLW Hardwood Walnut Finish Plate Stand 9" $3.25
227-PLB Hardwood Black Finish Plate Stand 9" $3.25
46-0190 Black Plastic 9" Stand with Gold Trim $1.75
50-0661 Adj. Brass Stand-Leaf $2.20
50-0664 Adj. Brass Stand-Fleur $2.20
50-0302 Brass Plate Stand $2.50
50-0104 Twisted Wire Brass Easel $2.50
  Merchandise Total

Shipping & Handling

Sales Tax-6% PA Only

Order Amount


Sub Total


$8.95 Shipping & Handling: See Chart


$10.95 **Priority Mail


$12.95 Insurance*-$2.00


$16.95 Total Amount

          $200.00 & UP


**If you wish to have your plates shipped Priority Mail please add an additional $4.50.
(International Customers & Customers from Alaska, Hawaii, Guam, Puerto Rico, Virgin Islands & APO addresses, please email or call for shipping charges.)




Method of Payment

Visa   **Security Code #_____ MasterCard   **Security Code #_____
Checks/Money Order (US funds only) Gift Certificate  
Account Number   Exp. Date
Cardholder's Signature                                                                                       

**Security Code Number is the Three digit number on the back of your card.

*Optional Insurance is for loss or damage of your Custom Picture Plates and accessories.  We can not insure your personal photos.


Federal Copyright Laws require that you must own the copyright to the image you wish to have re-printed, copied or produced, if you do not own the copyright, you must have permission from the owner of the copyright to have reproduction work done.  It is the policy of Halsey, inc to respect the Federal Copyright Laws and the rights of the copyright owners.  Please make every effort to abide by the Federal Copyright Law.

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halsey, inc  ~ Custom Picture Plate

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2003 Halsey, Inc
Custom Picture Plate

  St. Route 706 West P.O. Box 399, Montrose, PA  18801-0399
Phone Number 570-278-3610
All Rights Reserved