Custom Design Order Form

*Your Name: *
*Your Email Address: *
*Your Blog address: *
*Which Design Package would you like to order? *
Which Extras would you like in your Blog Design Package?
 Horizontal Navbar 
 Social Buttons 
 Blog Button W/Grab Code 
 Custom Sidebar Profile Pic 
 Custom Post/Sidebar Title Fonts 
 Post Signature 
 Post Divider 
 Sidebar Divider 
 Custom 'Pin it' Button 
 Post Title Image 
Which Add-Ons would you like to add to your order?
 Facebook Timeline Cover $35  
 Custom Logo Design $50 
 Etsy Banner $30 
 Business Card Design $30 
 Custom Watermark $20 
*What would you like your blog title/tagline {optional} to say? *
*What is your design style?
*What is your sidebar preference?
So I can get a better feel for your style, please list the URLs to blog designs that you admire! :
Do you have any specifics for me as to what you would like to see in your custom design?
*Who were you referred by?
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