EAGLE GIFTS GALORE
2063 S. HELLMAN AVE., SUITE C, ONTARIO, CA 91761   Voice: (909) 947-6634
Fax: (909) 947-6666 e-Mail:  egg@eaglegiftsgalore.net     http://www.PatchPlaques.net
BUDGET  ARROW  CEREMONY
MULTIPLE  PLAQUE   ORDER  FORM


If you are ordering plaques for several Boys in your group, it is not neccessary to fill out a separate form for each one.
You may use this form.   If you are ordering a plaque for YOUR son only, you may use Budget Plaque Order Form

*Enter the Date the Arrow Patch was (will be) earned in the boxes next to the rank names.
NOTE: If exact date is not known, just enter the month & year, or the year only.
**Print as many copies of page 2 as you need to list all of your Boys.
Use your browser's "Print" feature to print this form, sign it, and Fax or mail it to the address above.

Please do NOT send Credit Card information via eMail.

Add'l. Plaque Shipping
  Plaques qualify for "Additional Plaque Shipping"*  
  if they meet the following requirements: 
  • Ordered at the same time    
  • Shipped at same time, and  
  • Shipped to same address.    
*First plaque is always $ 9.00 shipping & handling; additional plaques receive discounted rate.
Quantity Discount
Due to the LOW price of this plaque, Budget Plaques do NOT qualify for the Quantity Discount


Budget Arrow Patch Plaque $ 19.95 Each
First Plaque Shipping and Handling     $   9.00
Additional Plaque S and H       $ 2.50 Each
California Residents add 7.75% Sales Tax
All Prices Subject to Change

GROUP INFORMATION
Group Name & Number     Date Plaques Needed By:    -   -
Contact Person Name        Group Position:  




* * * * * * * * * * * * * * * * * * * * * * * *




GROUP  ONE
The following       (# of ) Boys have: Rank Patch ouline will be Oval unless box is checked.
Arrow Patch Date:     - -   Diamond Rank Patch
GROUP  ONE  Boys'   NAMES:
  Boy # 1 Name   Boy # 2 Name
  Boy # 3 Name   Boy # 4 Name
  Boy # 5 Name   Boy # 6 Name



GROUP  TWO
The following       (# of ) Boys have: Rank Patch ouline will be Oval unless box is checked.
Arrow Patch Date:     - -   Diamond Rank Patch
GROUP  TWO  Boys'   NAMES:
  Boy # 1 Name   Boy # 2 Name
  Boy # 3 Name   Boy # 4 Name
  Boy # 5 Name   Boy # 6 Name



GROUP  THREE
The following       (# of ) Boys have: Rank Patch ouline will be Oval unless box is checked.
Arrow Patch Date:     - -   Diamond Rank Patch
GROUP  THREE  Boys'   NAMES:
  Boy # 1 Name   Boy # 2 Name
  Boy # 3 Name   Boy # 4 Name
  Boy # 5 Name   Boy # 6 Name



GROUP  FOUR
The following       (# of ) Boys have: Rank Patch ouline will be Oval unless box is checked.
Arrow Patch Date:     - -   Diamond Rank Patch
GROUP  FOUR  Boys'   NAMES:
  Boy # 1 Name   Boy # 2 Name
  Boy # 3 Name   Boy # 4 Name
  Boy # 5 Name   Boy # 6 Name
* * * * * * * * * * * * * * * * * * * * * * * *






ORDER   SUMMARY
 Budget Plaques   @   $ 19.95   = 
 
    X     7.75 % Tax *   = 
 
1st Plaque Shiping & Handling      @    $   9.00   =  $   9.00
 Additional Plaques S & H  @   $   2.50   = 
Grand Total     = 
* California Residents only

Billing Address
  Parent's Name      Home Phone     - -
Address 1     City    
Address 2     State     Zip    
E-Mail     Cell/Wk Phone     - -


Shipping Address (if different)
  Name       Phone     - -
Address 1     City    
Address 2     State     Zip    
We must have a phone number for the shipping address.

PAYMENT   INFORMATION:
  Check Enclosed
  Please charge my Credit Card
CREDIT  CARD   INFORMATION:
Name on Credit Card:
First NameMiddle NameLast Name
Please make sure that the Billing Address (above) is where the credit card statement is sent.
  Credit Card Type:      Visa     Mastercard
CREDIT   CARD   NUMBER: EXPIRATION   DATE
        
 
Signature: ____________________________________________________