EAGLE   GIFTS   GALORE
2707 S. DESERT FOREST AVE., ONTARIO, CA 91761   Voice: (909) 947-6634
Fax: (909) 947-6666     e-Mail:  egg@EagleGiftsGalore.net     http://www.EagleGiftsGalore.net
EAGLE   PATCH  ORDER  FORM


Fill in and print this form, sign it, and Fax or mail it to the address above.
Please do NOT send Credit Card information via eMail.
All prices subject to change.




SIZE QUANTITY PRICE SUBTOTAL
2" Round Eagle Patch    $     3.50
Jumbo 5-1/2" Round Eagle Patch    $   10.00
Shipping & Handling
2" Round Patches:
  1 - 5 Patches
  6-10 Patches
  11 + Patches
 $   2.00
 $   3.50
 $   6.00
Shipping & Handling
Jumbo 5-1/2" Round Patches:
  1 - 2 Patches
  3 + Patches
 $   3.00
 $   6.00
California Residents add 8.75% Sales Tax.  Patch sizes may be combined to save on S & H.
Orders of 1-2 Jumbo & up to ten 2" Patches will ship First Class.
Orders for 3 or more Jumbo and 11 or more 2" Patches will ship Priority Mail.
Call for Quantity Discount on orders of 20 Patches or more.

ORDER   SUMMARY
 
Total # of Patches     @     $     3.50   =   
Total # of Patches     @     $   10.00   =   
Calif. Sales Tax *   @     8.75%   =   
Shiping & Handling   @     =   
Total Order   = 
* 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    







EAGLE   GIFTS   GALORE
2707 S. DESERT FOREST AVE., ONTARIO, CA 91761   Voice: (909) 947-6634
Fax: (909) 947-6666     e-Mail:  egg@EagleGiftsGalore.net     http://www.EagleGiftsGalore.net
EAGLE   PATCH  ORDER  FORM   PAGE   2



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: SECURITY   CODE:
    (on back of card)
                  
 
 
Signature: ______________________________________________________________________________________