NOTE - DO NOT USE "ENTER" KEY ANYWHERE ON THIS FORM.  It sends the order incompleted. Thanks.

** 9-1-2010 -  Current estimated turnaround time right now is approx 6-7 weeks. Currently machining orders from 7-18. Volume is very heavy, Expect delays.  Orders will be cut in the order in which they are received ****

Your Name **   

Address **     

Apt or Suite                        

City **   State **    Zip ** 

Contact Phone **     Email **   I do not sell or share this number. It is for only if I have questions.

Organization

   **   ASTERISK INDICATES REQUIRED FIELD -  REQUIRED ITEMS MUST BE PRESENT OR ORDER WILL NOT BE PROCESSED !!

Please indicate what you would like the lines to read. This is a sample layout of how you want it to read. Where the individuals name goes put NAME and where the title will go put TITLE. You will be asked later on this form for the individuals names and titles.

Line 1

Line 2

Line 3

Line 4

Line 5

Line 6

Emblem Desired  Samples at Emblems We Stock page

Emblem Position none selectedCenter MiddleCenter RightCenter LeftTop MiddleTop RightTop LeftBottom MiddleBottom RightBottom Left  ** Emblem will be centered if not specified**

Badge Color none selectedWHITE face BLACK lettersWHITE face BLUE lettersWHITE face GREEN lettersWHITE face RED lettersLIGHT BLUE face WHITE lettersAZURE (MED) BLUE face WHITE lettersAIR FORCE (DARK) BLUE face WHITE lettersAZURE BLUE face YELLOW lettersALMOND face BLACK lettersPURPLE face WHITE lettersRED face WHITE lettersBLACK face WHITE lettersRED face YELLOW lettersBLACK face YELLOW lettersYELLOW face BLACK lettersYELLOW face BLUE lettersLIGHT GREEN face WHITE lettersDARK GREEN face WHITE lettersBURGUNDY face WHITE lettersGREY face WHITE lettersGOLD face BLACK lettersSILVER face BLACK letters

Badge Style None SelectedMen's Pocket slip-onMens FlatLadies Flat

List the individual names that you would like to appear on the badges with their perspective titles. If no titles are to be used just leave the title box blank.

Please double checkyour entries as I am not responsible for misspelled names on the orderform.

                              NAMES                                                                TITLES

1              

2              

3              

4              

5              

6              

7              

8              

9                

10             

11             

12            

13          

14           

15           

16          

17          

18          

19          

20          

Add on accessories   enter quantity in box

Magnets   **Do not use if you have pacemaker**

R1 Life Rose

F1 US Flag

Extra Emblems         Which emblem  

PGK PFN FDD FM Emblems     Which office Select OnePast Faithful NavigatorFormer District DeputyFormer MasterPast Grand Knight ** PGK Temporarily out of stock**

Safety Pin Fasteners    Comes standard on flat badge style

Bulldog Clips

C2 30 inch neck Chains

NOTE  if the add on accessories are to be shipped loose and not on the badges please specify this in the comments. Otherwise they are applied to the badges.

Comments and special instructions   

Method of Payment; Select OneUse the 30 day account that I already set up under my name.Customer will call or fax in Credit Card information.Use the Credit Card I left on file with you.                        

If paying by credit card, Please call me or fax me with the information, as this form does not meet security standards to enter card numbers. I am working to resolve that situation. Nobody sees faxes but me.  Call  804-790-1566  Monday thru Friday 9am till 4pm  EST. Fax is the same number, 24hrs. I need card type ( visa, Mastercard, ect.), account number, expiration date, and CVV security code ( last 3 digits off back strip. AMEX uses 4 small digits on face. ) Credit Card orders will not be processed until card information is received.

Existing Personal Accounts, - Accounts are under YOUR personal name, not a Organization.  Requestor of services is PERSONALLY responsible for payment, paid in full by the due date. Due date will be printed on each invoice. In the event of default of payment when due, all collection costs, including attorney's fees and court costs, shall be paid by the Requestor of services. Fraternal Supply holds no affiliation of agreements made between Organizations and it's members over payments. CP ( Credit card posted ) accounts are billed as 30 days. If payment not received by due date, the card on file will be billed. Collection information applies the same as posted above if card is bad.

Final Note

Once a badge is cut it cannot be re-engraved.

If there is a misspelling that is my fault I remake it at no charge.

Double check all your information you entered and selected.

Your badges will be made the color you selected. I am not responsible if you select the wrong color.

Hit SUBMIT QUERY only once so it does not submit duplicate orders.

Badges are custom made. ALL SALES FINAL, No Refunds. Once they are cut... They are yours.

             Sends Order                      Clears all entries

 Due to the volume of orders I receive, Badge orders are processed in the order in which they are received.