Order form for
215
So. Broad St. 3rd Floor, Philadelphia, Pa 19107, Phone; (800) 786-5890
Recipient:_____________________________________________________________________________
National Number:___________________ Date______________________________________________
Send To: ____________________________________________
Street: ______________________________________________
City:___________________________ State:___________________ Zip Code____________________
Telephone Number ___________________________________
Please charge my purchase to: Check Enclosed:___________________
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American Express |
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Expiration Date: ______________________________________
Credit Card Number: __________________________________
Mark 1, 2, 3, etc., beside all available items desired. Call for price of 14k pins.
Emblem.................................................................... $50.00
State Bar...................................................................... 35.00......................................... State
Name
Ancestor Bar............................................................... 35.00......................................... Ancestor
Name
Recognition Pin......................................................... 42.00
Miniature Emblem..................................................... 38.00
Chapter President..................................................... 50.00......................................... Chapter
Name
Ex Chapter President................................................ 52.00......................................... Chapter
Name
State President.......................................................... 70.00......................................... State
Name
Ex State President..................................................... 72.00......................................... State
Name
Honorary State President......................................... 72.00......................................... State
Name
State Chairman.......................................................... 56.00
Ex State Chairman.................................................... 60.00
State Officer................................................................ 50.00......................................... Office
Held
Ex State Officer........................................................... 52.00......................................... Office
Held
State Officer Club....................................................... 52.00
Chairman National.................................................... 60.00......................................... Committee
Held
Officer National.......................................................... 60.00......................................... Office
Held
Officer National Club................................................. 45.00
25 and 50 Year Pins (Circle one)........................... 38.00
Restoration Sponsor................................................ 50.00......................................... $1000
Donation
Restoration Patron.................................................... 50.00......................................... $5000
Donation
Restoration Commodore......................................... 58.00......................................... $10,000
Donation
Headquarters House................................................ 52.00
Page Pin...................................................................... 48.00 Engraving
Instructions
Centennial Charm..................................................... 35.00
Centennial Pin........................................................... 35.00 ___________________________
Disc Charm................................................................ 45.00
History Prize................................................................ 40.00 ___________________________
Endowment................................................................ 45.00
Flora Adams............................................................... 43.00 ___________________________
Associate Council..................................................... 52.00
Appointed National Officer....................................... 48.00 ___________________________
Junior Pin.................................................................... 38.00
Association of State Presidents............................. 42.00 ___________________________
There
is no charge for engraving. Please add
$4.00 for shipping,
Add
7% sales tax for orders shipped to Tn,
Sc, Fl, Nc, Ga, Al, Va, Wva, De, Nj and Pa (Per Irs Code)
Signature of State President:_______________________________________
Signature of President National (a must):_____________________________
Mrs. William E. Slinkard; 1566 Princeton Drive, Cape Girardeau, MO 63701-2566
Make
three copies, one for chapter, one for National Society, and one for J.
E. Caldwell