pocket badge order form
TRANSCRIPT
POCKET BADGE ORDER FORMIMPORTANT: A purchase order, money order, credit card number, or letter of authorization
MUST accompany all orders. Please allow 3 to 4 weeks for delivery
WALTER CURTIS CO., LLCP.O. BOX 600DEWITT, MI 48820-0600
visit us at: www.pocketbadge.com
Badge Stand$8.00To display or storeyour I.D. Badge
I.D. Badge Stand
Recommended Case $10.00Deluxe hard shell case withvinyl cover and paddedinterior for protection.
I.D. Carrying Case
TYPE OR PRINT YOUR ORDER EXACTLY AS YOUWANT IT TO BE READ
Top Plate (use one or two lines)
A
B
Bottom Plate (use one or two lines)
Title Ribbon
Badge No. orCustom Badge
State or Other Seal
QUESTIONS? (800-783-8762)
Max. 35 Characters and Spaces per Line
Max. 35 Characters and Spaces per Line
PLASTIC HOLDER STYLERB-1 SP-3 FS-2
UNIFORM NAME BADGE
FS-2 ATTACHMENT TYPE
CLIP PUSH PINS MAGNET
CHAIN $2.00
MOURNING BAND-NO CHARGE
LANYARD -NO CHARGE
VISA MASTERCARD CHECK (payable to Walter Curtis LLC)
GOVERNMENT AGENCY
SHIP TONAME
AGENCY
ADDRESS
CITY / STATE / ZIP
PHONE
PURCHASE ORDER NUMBER(terms Net 30 Days)
ALL I.D. BADGES $46.00 POSTAGE PAIDReplacement plates available (A&B)
$15.00 each factory applied $10.00 each self applied
FAX ORDERS TO (517) 668-603Scan completed form & email to [email protected]
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Orders must be mailed, emailed or faxed. (no phone orders please)
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DUPLICATE FORM FOR ADDITIONAL ORDERS
CARD NO.3-DIGITSEC. NO.
EXP. DATE SIGNATURE
GOLD SILVERFINISH