Custom Quote Form
Instructions: Please complete this form to receive a written quotation.  

By completing this form, you are authorizing Medallic Hawaii to contact you directly by phone.

Please be as specific as possible. Your artwork is not required initially, but can be very useful
in providing a more accurate quotation.

Please send your artwork directly to: Artwork@medallichawaii.com.   We gladly accept Adobe
Photoshop, Illustrator,  JPG, GIF, TIF, EPS, & PDF images.
Custom Quote Form
* Required Field
*Your name:
*Email:
*Company:
Address:
State:
 Zip:
City:
*Phone:
*Fax:
Select Coin Features
Proof Mint Design
Enamel Design
Hold down Ctl
key and select
multiple
Features
*Quantity:
Order Minimum is 100
*Diameter:
1/2"  3/4"  1"  11/4"  11/2"  Larger,  Custom
Comparison
1 1/2" diameter is the
most popular size
which is similar to a
U.S. Silver Dollar
1"
11/4"
 3/4"
Upcoming Anniversary
or Special Event:
Completion Date:
*Comments
Privacy Statement
Customer Service
Hand written Design Form: Please complete this fax form to receive a written quotation.  
Double click on fax-ready form below and print out.
(double-click to expand and print)
By completing this form, you are authorizing Medallic Hawaii to contact you directly by phone.