PRISM Pin Order Form
Please complete the form below to order your Prism Pins. Once your form has been submitted, confirmation of your order will be sent to the email address you enter below. If your order is correct, please forward your payment and your order will be shipped once payment has been received. PLEASE ALLOW 2-4 WEEKS FOR DELIVERY.
Your info
Your Name
First Name
Last Name
Club Name
Email
example@example.com
Shipping Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Products
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Rainbow Ribbon
$
1.00
CAD
Quantity
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Rainbow Pin
$
2.25
CAD
Quantity
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Red Pin
$
2.25
CAD
Quantity
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Orange Pin
$
2.25
CAD
Quantity
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Yellow Pin
$
2.25
CAD
Quantity
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Green Pin
$
2.25
CAD
Quantity
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Blue Pin
$
2.25
CAD
Quantity
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Violet Pin
$
2.25
CAD
Quantity
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Shipping Fee
$
15.00
CAD
Quantity
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Additional Notes/Requests
I will be paying for my order by
E-transfer - payment can be sent to payments.rga@gmail.com
Cheque - please mail to 11759 Groat Road, Edmonton, AB, T5M 3K6
Thank you for your order!
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