Custom Order Form
Company Name
Name
*
First Name
Last Name
Email
*
example@example.com
Contact Number
*
Please enter a valid phone number.
Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Billing Address
*
Same as Shipping Address
Billing If Different
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Product
*
Please Select
Eco Galaxy
Tyvek
Silicone
Cashless Adhesive
Cashless Fabric
VIP Passes
Lanyards
Size
*
Please Select
1 Inch
3/4 Inch
Quantity
*
Rush order(15 business days or less)
*
Yes
No
Delivery/ In-hand Date
Imprint Color
*
One Color
Full Color
Wristband Color
e.g. Blue, Red, Yellow, Black etc.
Numbering
*
Yes
No
Numbering Example
e.g. 1001 - 5001
Barcode/QR Code
*
Yes
No
RFID
Yes
No
Custom Design
*
Yes
No
Previous Order #
Additional Comments
Need Further Assistance?
Feel free to Call us on our Toll Free# 1-866-815-7550 or Email us on customorders@medtechgroup.com
Submit
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