Custom Designed Certificates Information Form
Individual Awards ~ Retirement ~
Certificates of Appreciation

This is not a payment form.

Individual Award and Custom Designed Certificates can run from $64.00 to $120.00 depending on the work involved. You will make your payment after we have gone over your certificate information and have given you a price quote.

Fill out the information, then click the
"Submit" button at the bottom of the page.

We guarantee all of your information will be held confidential.

We will be contacting you about the layout and wording of your certificate. Please give us your contact information.

Your Name:


City: State: Zip:

Telephone Number:

Secondary Telephone Number:
Best time to call?
E-Mail Address :
Unless requested otherwise, we will be sending image proofs by e-mail.
Certificate Information
Military Service if needed: (Army, Navy etc.)
What kind of certificate do you need?:
Award or Occasion:
Name to be placed on Certificate:

Message- tentatively: Give us the basic message you would like to be on your certificate. You can copy from a certificate you see on our site or write your own. Don't worry if you have a hard time with the wording. We can help you with that.

Name or names of the person or persons who are honoring the recipient:

Title if needed:

Organization or Business name if needed:

Salutation: If you would like one. A second one may be placed depending on the room we have.
Choose one:
Thank You!
We are Proud to call YOU Our Own
With Heartfelt Gratitude
God Bless America ~ God Bless You (a star can be placed in the center as on samples shown.)
If you have one of your own please write it in the box below:
If you would like a Presentation Date:
Choose one:
Presented this...
Given this...
Date Style:
Fourth Day of July, Two Thousand and Sixteen
11th Day of November, 2016
February 15th, 2106

Additional Information:

Check if you would you like to have your certificate placed into a plaque?

How did you find out about us?:

Please check if we have your permission to use your finished certificate as a sample on our website or other publications?

Click once. Thank you for your patience.
If you would rather pay by phone please give us a call at the number below or send us an e-mail and we will get back with you. Checks and Money Orders are accepted as well as credit/debit cards.

Satisfaction Guaranteed!

CJM Military Certificates
Formerly CJM Certificates

If you would rather pay by phone:
Toll Free: (866) 447-1011

We take credit/debit, check or money order.