TROPHY ORDERS


 INSTRUCTIONS:

 Ü Input your name, Branch/Unit, and billing address in the fields below.
 Ü Input the number of each item in the table below.
         NOTE:  Do not input any data in the TOTAL column.  If necessary, click the CALCULATE button below.
 Ü Print the form and forward to:
            Norm Combs, 1008 Foxtail, Grain Valley, MO  64029-9110  
 
NAME

BRANCH/UNIT

BILLING ADDRESS

 
TROPHY
EACH
COST
TOTAL
• White Base
$12.50
$
• Black Base
$12.50
$
• Walnut Base
$12.50
$
ENGRAVING   input engraving text here
EACH
COST
TOTAL
• Black – Silver Lettering
FREE
$
• Black – Gold Lettering
FREE
$
• Polished Brass
FREE
$
TOTAL AMOUNT                 
$