TGPCHPCMY2KMR + 9
Name Badge Order Form

(Please print this form with the PRINT button on your browser, fill it in and either mail or fax it to the vendor.)

Name badge includes your name, your bike's nickname, year, make and state.  There are three name badge attachments to choose from (pin, magnet and lapel clip) and the prices vary accordingly.  There are also two styles of badge: +9 and P.A.T. (see samples below).

Indicate quantity:
 

+9 Pin:       _______($11.00) P.A.T. Pin:       _______($11.00)
+9 Magnet:_______($13.00) P.A.T.. Magnet:_______($13.00)
+9 Clip:      _______($11.00) P.A.T. Clip:      _______($11.00)
Subtotal......................................................................................__________
7.25% sales tax (California residents only)............................__________
Shipping & handling (contact Arnold's for amount).........__________
Total enclosed.........__________
Visa/MC/Amex Account #_______________________________ Security Code #________________ (last 3 digits on the rear of the card or 4 digits on the front for Amex)

Expiration Date: ________________________

Your Name_________________________________________(Please type or print)

Your Bike Nickname__________________________________

Model year of your bike _______________________________(last two digits)

Make or model of your bike_____________________________(e.g., PC, BMW, ST - abbreviate please)

State in which your bike is licensed_______________________ (two character abbreviation)

Your phone number, including area code, in case of questions:____________________________
 
 

Fax your order to: (530) 677-6065
    OR		 Sample badges (actual size is 3 1/16 x 1 5/8):
Mail your order to:

Arnolds For Awards
3791A Durock Road
Shingle Springs, CA 95682

(Allow two weeks to receive your name badges.)
Name/Address badge is to be mailed to:

_________________________________________

_________________________________________

_________________________________________
 
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