2014 NAWS Order Form
SUDBURY AREA ORDER FORM JANUARY 2017
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TOTAL ______
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TOTAL
KEYTAGS
CHIPS
Welcome (White) / 4100* / $.90 / Welcome (White) / 4200 / $.90
30 Days (Orange) / 4101* / $.90 / 30 Days (Orange) / 4201 / $.90
60 Days (Green) / 4102* / $.90 / 60 Days (Green) / 4202 / $.90
90 Days (Red) / 4103* / $.90 / 90 Days (Red) / 4203 / $.90
6 Months (Blue) / 4104* / $.90 / 6 Months (Blue) / 4204 / $.90
9 Months (Yellow) / 4105* / $.90 / 9 Months (Yellow) / 4205 / $.90
1 Yr (Moonglow) / 4106* / $.90 / 1 Yr (Moonglow) / 4206 / $.90
18 Months (Grey) / 4107* / $.90 / 18 Months (Grey) / 4207 / $.90
Multiple Yrs (Black) / 4108* / $.90 / Multiple Yrs (Black) / 4208 / $.90
TOTAL
BRONZE MEDALLIONS AND HOLDERS
TOTAL
DESCRIPTION / ITEM NO. / QUANTITY / UNIT PRICE / TOTAL / DESCRIPTION / ITEM NO. / QUANTITY / UNIT PRICE / TOTAL18 Months / 43 / $5.75 / KEYCHAIN / HOLDERS
Year / 43 / $5.75 / BLACK / 6091 / $12.00
Year / 43 / $5.75 / GOLD / 6092 / $12.00
Year / 43 / $5.75 / BRONZE / 6093 / $12.00
Year / 43 / $5.75 / These fit triplates
Year / 43 / $5.75 / triplates
TOTAL
TRI-PLATE MEDALLIONS GREEN
1 year thru 55 years, 18 months, and eternity are available.
Please indicate year required after item number.
TRI-PLATE MEDALLIONS PURPLE
DESCRIPTION / ITEM NO. / QUANTITY / UNIT PRICE / TOTALYear / 61 / $37.00
Year / 61 / $37.00
Year / 61 / $37.00
TOTAL
TRI-PLATE MEDALLIONS BLUE
TOTAL
TRI-PLATE MEDALLIONS RED
DESCRIPTION / ITEM NO. / QUANTITY / UNIT PRICE / TOTALYear / 63 / $37.00
Year / 63 / $37.00
Year / 63 / $37.00
TOTAL
TRI-PLATE BLACK
TOTAL
TRI-PLATE PINK
DESCRIPTION / ITEM NO. / QUANTITY / UNIT PRICE / TOTALYear / 65 / $37.00
Year / 65 / $37.00
Year / 65 / $37.00
TOTAL
TRI-PLATE GOLD
TOTAL
TRI-PLATE VIOLET
DESCRIPTION / ITEM NO. / QUANTITY / UNIT PRICE / TOTALYear / 67 / $37.00
Year / 67 / $37.00
Year / 67 / $37.00
TOTAL
TRI-PLATE ORANGE
TOTAL
LASER MEDALLION
DESCRIPTION / ITEM NO. / QUANTITY / UNIT PRICE / TOTALYear / 69 / $37.00
Year / 69 / $37.00
Year / 69 / $37.00
TOTAL
Tri-plate medallions available 1 thru 50 years, 18 months, and eternity.
Please indicate year required.
PAGE TOTAL ______
SUBTOTAL PAGE 1
SUBTOTAL PAGE 2SUBTOTAL PAGE 3
SUBTOTAL (pages 1, 2 3)
ORDER TOTAL
Deposit funds at any TD Bank
Account #382 Transit # 3712
S.A.L.C.N.A
ATTACH BANK RECEIPT TO COMPLETED ORDER FORM
COMPLETED CONTACT INFORMATION IS REQUIRED TO PROCESS ORDER. Please verify order totals and quantities for accuracy. All incorrect or incomplete orders will be returned to groups.
GROUP NAME______CONTACT PERSON______
PHONE NUMBER______
Email orders can be submitted to
Copy and paste order and send it to email address above.
Completed orders will be ready at the area meeting
And can be picked up upon presentation of bank receipt!
Any concerns or comments can be forwarded to Bob W.