St. Francis Animal Sanctuary Custom Tag Order Form

P.O. Box 677 * Abita Springs, LA * 70420 * 601.222.1927

 

INSTRUCTIONS FOR COMPLETING THIS FORM:

Please PRINT this form and fill it out completely and clearly.  Please MAIL the completed form to the address above; include your check or complete the credit card information below.  Please allow up to 3 weeks for delivery.  Please use ONE ORDER FORM PER SET (you may pay for them together and mail them together).

Order your set of three (3) identical tags for $21.00 plus $5.95 shipping/handling (includes brass connector rings).
Indicate your choice:

 

□  Large Heart (Red Only)             □  Small Heart (Pink Only)

□  Large Circle-Black                     □  Large Circle-Gold          

□  Small Circle-Black                     □  Small Circle-Gold          

□  Large Bone (Blue Only)             □  Small Bone (Blue Only)

 

* Maximum of four (4) lines PER SIDE (both sides can be engraved)

* Maximum of twelve(12) letters PER LINE for Small Heart; maximum eighteen (18) letters
  PER LINE for all other tags

 

FRONT:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BACK:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total sets ordered:             #__________________Ship to:_____________________________________

x $21.00 per set:                  $__________________           _____________________________________

S/H:                                        $5.95                                   _____________________________________

Total amount of order:       $__________________             _____________________________________

□  Check Enclosed  □  Charge my card: Type of card:            (  )MC (  )VISA (  )AmEx

Name on card:                      ___________________________________________________________

Address as on stmt:             ___________________________________________________________

                                  ___________________________________________________________

Card#: ___________________________________________________________
3-digit code on back of card (MC/V):__________ or 4-digit code on front of card (Am/Ex):__________

Exp.    ____________            Signature:            _____________________________________________

Phone:____________________________Email:_________________________________________