Memorial Brass - Printable Order Form

Printable Order Form

To order by mail, print order form, complete and mail with check or money order to:

Memorial Brass
Lemuel Carl House
939 State Route 197
Argyle, NY 12809
Phone: 518-638-6292

Fill in the form below exactly as you want your tag stamped. (See example at right.) Please print clearly in uppercase letters and numerals. One letter/punctuation per space.

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[Please Type or Print]

Sender's Name_____________________________________________

Street Address____________________________________________

City, State, Zip__________________________________________

Daytime Phone_____________________________________________

Evening Phone_____________________________________________

How did you hear of us:

[ ] Friend
[ ] American History
[ ] Military History
[ ] Civil War Journal

[ ] America's Civil War
[ ] The Civil War News
[ ] Adirondack Regional Chambers of Commerce
[ ] Civil War Times Illustrated
[ ] Sutler, in the Field

Item	Quantity	Cost each	Total
Unstamped Civil War ID Tags	_______	X $15.00	$_________
Custom Stamped Civil War ID Tags	_______	X $35.00	+ $_________
About Shipping Charges We ship USPS ( United States Postal Service ) New York State Residents add 8% sales tax Shipping & Handling is INCLUDED. Make checks and money orders payable to "Memorial Brass"			= $ _________ Subtotal + $ _________ Tax $_________ Total

SHIP TO Address (if different than above):

Name _____________________________________________

Street Address ______________________________________

City, State, Zip ______________________________________

Country ___________________________________________