Safari Motorcoaches - Badge Order Form

OWNERS
Badge Order Form

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Product Line-Up:

PIN-ON TYPE NAME BADGE
New members are entitled to one pin-on badge per person FREE! Your name and the Safari Logo will be engraved on a badge which can be pinned on your shirt. The order form for this badge is included on the "Membership Application & Badge Order (PDF)" form.

REPLACEMENT BADGES
Lost your name badge or just need a new one? Your name and the Safari Logo engraved on a badge. Price $6.00 each for badge only.

NAME ON BADGE INFO. (Please print name as you want it to appear)

1. Your First Name or Nickname _______________________ Last Name_______________________
Replacement $6.00_________

2. Your First Name or Nickname _______________________ Last Name_______________________
Replacement $6.00_________

MAIL TO:

Name:__________________________________________________________
Address:__________________________________________________________
City:_______________________ State:_________ Zip:_________

FOR OFFICE USE ONLY

Date Recieved_______ Check/Cash_______ Date Ordered_______ Date Sent_______