Information Request Form

Select the items that apply, and then let us know how to contact you.

Send  Coastal clocks product brochure
Have a salesperson contact me

To Place an Order:

To place an order for custom built clocks or clock parts. Contact us either by filling out form below, by email sent to mnista@prodigy.net or  by phone 781-837-3916. For Your convenience and credit cards are now accepted.

 For security reasons we ask you do not submit  your credit card information using this form. We will contact you to take your order over the phone .

To ensure timely order processing please be ready with the following information when placing order:

Cardholder's Name:

Billing Address: 

City, State, Zip Code:

Home Telephone #:

Credit Card #:

Exp. Date:

Once credit card information has been taken for your transaction you accept responsibility for payment to Coastal Clocks.

A deposit of 50% is requested to secure a place  on my schedule with the balance due upon completion.

Shipping will be arranged depending on the size and weight of items shipped.