Has church ordered previously? Select Yes No   Order Date      Date Needed

Person Ordering       Position

Church Phone   ext.    Church Fax

Day Phone  ext. Is that # select work home ?

E-mail address 

We need Church information before processing any order.  We prefer shipping to the Church.

Church Name  

Church Delivery Address (include street, city, state & zip)

Church Billing Address if different (include street, city, state & zip)

Ship to if different than Church: select work home (include street, city, state & zip)

Method of Payment (Check one):

         Select Church Purchase Order Bill to Church Sent Check Church Credit Card Personal Credit Card

        Please indicate in the box below:

    *If ordering by Church Purchase Order indicate Church Purchase Order Number;

    *If ordering by Check indicate Check Number;

    *If ordering by Church Credit Card indicate Type of Card, Card Number & Expiration Date;

    *If ordering by Personal Credit Card indicate Name on Card, Type of Card, Card Number, Expiration Date,

Daytime Phone of Cardholder, Street Address & Zip only.

Tax Exempt #

    1)     Choose from stock or custom bracelets:

             Select Stock Plastic Reusable Bracelet Custom Printed Plastic Reusable Bracelet Blank Plastic Reusable Bracelet

   2)    Color:   Select Yellow Orange Pink Blue

   3)    Quantity: 

   4)    Price Per Bracelet Per Color as indicated above: 

   5)    Total Price for Entire Quantity: 

   6)    Set-Up Charge (for Custom Only) Select Custom- Add $50.00 To My Order Stock- Do Not Add $50.00 To My Order

   7)    Imprint for Custom Orders:

   8) If you are ordering additional items please use the spaces below:

    10)    Shipping Charges as indicated below:  

Stock SHIPPING SCHEDULE: General Shipping for items shipped from our in-stock products.

$0-25 =$7.50   $26-50 =$8.00   $51-100 =$8.50   $101-150 =$9.50   $151-200 =$10.50

Add $1 for every $50 over $200 (Some items may be more / EX. mugs, squeeze bottles, etc.)

Add approximately $10 for UPS 3 day select / $15 for UPS blue 2 day service

Please Note: If you are ordering two or more stock items EX: Kiddie Keepers and Stock Diaper Bag Tags add one shipping charge to the total order.  Stock shipments are totaled and shipped together from our office.

    11)    Total Purchase Amount:

We consider it a blessing to be a part of your ministry!!!

Jamie Cardell, Pam Reeves, Christy Godfrey, Deanna Burkhardt and Joy Carlisle