Ornament Order Form
First Name*
Last Name*
Primary Phone Number*
Alternate Phone Number
*Email Address:
*Mailing Address:
*City:
*State/Province: ALBERTA, CANADA BRITISH COLUMBIA, CANADA CANADA, CANADA MANITOBA, CANADA NOVA SCOTIA, CANADA ONTARIO, CANADA ONTARIO, CANADA QUEBEC, CANADA SASKATCHEWAN, CANADA ALABAMA, UNITED STATES ALASKA, UNITED STATES APO AA, UNITED STATES APO AE, UNITED STATES APO AP, UNITED STATES ARIZONA, UNITED STATES ARKANSAS, UNITED STATES CALIFORNIA, UNITED STATES COLORADO, UNITED STATES CONNECTICUT, UNITED STATES DELEWARE, UNITED STATES DISTRICT OF COLUMBIA, UNITED STATES FLORIDA, UNITED STATES GEORGIA, UNITED STATES GUAM, UNITED STATES HAWAII, UNITED STATES IDAHO, UNITED STATES ILLINOIS, UNITED STATES INDIANA, UNITED STATES IOWA, UNITED STATES KANSAS, UNITED STATES KENTUCKY, UNITED STATES LOUISIANA, UNITED STATES MAINE, UNITED STATES MARYLAND, UNITED STATES MASSACHUSETTES, UNITED STATES MICHIGAN, UNITED STATES MINNESOTA, UNITED STATES MISSISSIPPI, UNITED STATES MISSOURI, UNITED STATES MONTANA, UNITED STATES NEBRASKA, UNITED STATES NEVADA, UNITED STATES NEW HAMPSHIRE, UNITED STATES NEW JERSEY, UNITED STATES NEW MEXICO, UNITED STATES NEW YORK, UNITED STATES NORTH CAROLINA, UNITED STATES NORTH DAKOTA, UNITED STATES OHIO, UNITED STATES OKLAHOMA, UNITED STATES OREGON, UNITED STATES PENNSYLVANIA, UNITED STATES PORTA RICO, UNITED STATES RHODE ISLAND, UNITED STATES SOUTH CAROLINA, UNITED STATES SOUTH DAKOTA, UNITED STATES TENNESSEE, UNITED STATES TEXAS, UNITED STATES UTAH, UNITED STATES VERMONT, UNITED STATES VIRGINIA, UNITED STATES VIRGIN ISLANDS, UNITED STATES WASHINGTON, UNITED STATES WEST VIRGINIA, UNITED STATES WISCONSIN, UNITED STATES WYOMING, UNITED STATES
*Zip:
Name of Ornament Select CCMS COHES WILLOW ELEMENTARY CORNWALL ELEMENTARY COVAC NWVAC STORM KING ENGINE HIGHLAND ENGINE MOUNTAINVILLE ENGINE ST THOMAS WOLVERINES CCHS
How Many?
Pick One Only- Name or Mascot / Date
Ornament total cost; $21.99 Each
Additional hanging mascots, dates & names: $3.00 each *Words have a limit of 14 characters.
Name of Mascot, Date, or Name
Charm total cost:
Subtotal:
Tax (8.125%):
Total:
Call me for credit info
Card Type Select Discover Visa Master Card American Express
Card # Expiration Date CVV#
Billing Address (If different than above)
To Fax: 215-243-6007