Use this form for orders of up to 30 badges. To order more than 30 badges you will have to fill out the form again in its entirety. Please fill in all required fields. The fields marked with a * are required for us to properly process your order.
CLUB INFORMATION / BILL TO
SHIP TO - if different
BILL TO CLUB..
.. OR PAY BY CREDIT CARD
VISA
MC
AMEX
DISCOVER
COST OF BADGES
FASTENER TYPES
Bulldog Swivel Clip:
No extra charge Specify A on Order Form
Clip & Pin Combo:
Add $0.75 Specify B on Order Form
Magnet Backing:
Add $1.25 Specify M on Order Form
* ROTARY CLUB NAME
Full Rotary club name exactly as it should appear on your badge
BADGE INFORMATION
Please fill out complete information for each badge ordered. When selecting Style RT-35 or RT-43 (Blue & Gold) please add the Term of Office in the appropriate field.
SPECIAL INSTRUCTIONS
All badges will be sent via first class mail unless otherwise instructed. Please feel free to add stock items below to ship with your order.
Please check all spelling and fill out all fields as required, including all information regarding the product(s) you are ordering. Your order cannot be processed if required fields are not filled. Check this box and click the Send Email button when ready.