Purchase order - Alpha Delta Pi
|Badge & Guard Order Form |
|ALPHA DELTA PI EXECUTIVE OFFICE |
|1386 PONCE DE LEON AVE NE |
|ATLANTA, GA 30306 |
|404-378-3164 | PHONE |
|678-510-2162| FAX |
|MEMBER INFORMATION: |SHIP TO: |
|NAME: |RECIPIENT NAME: |
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|Chapter: |Address: |
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|School: |City, State, Zip: |
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|Badge Engraving: |
|INITIATION DATE: |
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|INITIALS (FIRST, MIDDLE, LAST): |
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| |Metal Type: | | | |
| |STERLING SILVER (SS) | | | |
| |WHITE GOLD (10KW) |BADGE/GUARD DESCRIPTION: | |TOTAL: |
| |YELLOW GOLD (10KY) | | | |
|BADGE: | | | |
|GUARD: | | |☐ TRADITIONAL | |
| | | |☐ STICKPIN | |
| |SUBTOTAL | |
| |SHIPPING AND HANDLING |$9.00 |
| |TOTAL | |
|Payment INFORMATION: |
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|SELECT PAYMENT TYPE: VISA ☐ MASTERCARD ☐ CHECK ENCLOSED ☐ (MADE PAYABLE TO ALPHA DELTA PI) |
|Card Number: #### / #### / #### / #### |
|Card Expiration Date: mm / yy |
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|Credit Card Billing Address: (The address where the bill is sent each month.) |
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|Name on Card: |
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|Email Address: |
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|Phone Number: |
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|X |
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|EMAIL ORDERS TO: Badges@ |
|-OR- |
|MAIL ORDERS TO: 1386 PONCE DE LEON AVE NE |
|ATLANTA, GA 30306 |
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Note: Badge orders r[pic][?]:;TUfgs{|„ˆ‰Ž?üîßл¨»¨“€k“€Q4“»¨8h+1¤h+1¤B*CJOJPJQJ^J[?]aJmHnHphÿu[pic]2h+1¤B*CJOJPJQJ^J[?]aJmHnHphÿu[pic](h+1¤h?_ü;?B*CJOJQJaJphÿ%h+1¤hJT?B*CJOJQJaJphÿ(h+1¤hJT?;?B*CJOJQJaJphÿ%hí(UhJT?B*CJOJQJaJphÿ(hí(UhJT?;?B*CJOJQJaJequire 4-6 weeks for processing after they are sent from Executive Office to Herff Jones. View additional Herff Jones jewelry options at:
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