Victory Ribbon Order Form 

Ordered by:

First Name
Last Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Shipping Address (if different):

	SHIP TO:
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Number of Victory Ribbons Desired:    

Payment:

Paypal    
Personal Check
    (order will ship AFTER payment clears)
Business Check
   (order will ship AFTER payment clears)
Money Order

Shipping:

   $0.01 to 9.99..........$1.75
   $10.00 to 49.99......$3.50
   $50.00 to 99.99......$6.00
   $100 to 200............$8.00
   $200 and over........$10.00

 

Total Payment:

Number of Victory Ribbons @ 7.00 each.  Maryland residents add 5% sales tax (.35 per pin.)