Order Forms Main Menu District Badge Quantity: 1-10 | 10+

1-10 BADGE ORDER FORM - DISTRICT Badges (Rectangular)

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.

DISTRICT INFORMATION / BILL TO

District #
* Name
Care of
* Address
* City
* State/Province * Postal Code
* Country
* Day Phone
Fax
* Email

  SHIP TO - if different

Name
Care of
Address
City
State/Province Postal Code
Country
Day Phone
Fax
Email

  BILL TO DISTRICT..

.. OR PAY BY CREDIT CARD

VISA

MC

AMEX

DISCOVER

Credit Card
Number
Expiration
Date
Cardholder's
Name
BADGE STYLES

DISTRICT WHITE
Style DW-14

DISTRICT GOLD
Style DG-32

DISTRICT WHITE THEME
Style DWT-14

DISTRICT GOLD THEME
StyleDGT-32

DISTRICT WHITE THEME
Style DWT14-15A

DISTRICT WHITE THEME
Style DWT14-15B

DISTRICT WHITE THEME
Style DWT14-15C

DISTRICT WHITE THEME
Style DWT14-15D
 

COST OF BADGES

1 or 2 @ $9.95
3 to 5 @ $8.95
6 to 24 @ $7.95
25+ @ $7.25

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 DISTRICT NUMBER

Full Rotary district number exactly as it should appear on your badge

* YEARS AS YOU WOULD LIKE THEM TO APPEAR ON THE BADGES

If you do not want years on your badges please type NONE below

BADGE INFORMATION

Please fill out complete information for each badge ordered.

* Badge Style * Fastener
type
* Nickname or
First Name
*Last Name * Classification

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.

Check here if you've placed a separate order today, that you would like to ship with this order.

SPECIAL INSTRUCTIONS

All badges will be sent via Priority Mail unless otherwise instructed.