Sculpture Registration

By registering on-line or via mail you will be entered into the Collector’s Society and receive a Certificate of Ownership. Certificates can only be processes if all requested information is provided. If you do not wish to use this form, or your browser does not support it, you can send an email to [email protected], or print out the form and fax it to Starlite Originals at: 800-726-4670.

Registration Request

I purchased (sculpture title): *

With a certified limited edition number of:

Please register this sculpture to me as shown below:

Prefix

Full Name*

Address*





Telephone

Email*

Sculpture purchased from:

I am a *

Existing Collectors, please enter your membership I.D. #