Custom Color Backpainted Glass Sample Request
Once you’ve submitted this form, a member of the Element Designs team will contact you to confirm your order. Please note there is a one-time $75 fee for each custom color sample request. Each submission includes two 4" x 4" backpainted glass samples. Custom color approval is required before we can begin production on any orders using that color.

For any additional questions please contact: orders@element-designs.com

Email *
Name *
Company & Location *
Phone Number *
Project Name / Reference
PO Number
Estimated Install Date
Glass Thickness *
Glass Finish *
Paint Manufacturer *
Color Code / Color Name *
Additional Notes
A copy of your responses will be emailed to the address you provided.
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