Rebus regalia order form

Rebus Regalia Order Form
Name of Club*
Delivery Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Officer completing this order*

First NameLast Name
Phone Number*

Area CodePhone Number
Your email address*
example@example.com
Now order the items and quantity of Regalia from Rebus NZ Inc as listed below.

Remember to fill in any engraving in the box(s) at the bottom of this form
Click on image to enlarge. Tick the box by each item that you require, then add the quantity below the item. Minimum order $25
prevnext( X )
Name Badge with pin: Code REBUS-BDGPNo extra charge for title. Enter engraving details below
$12.60NZD Quantity



Name badge with magnet: Code REBUS-BDGMNo extra charge for title. Enter engraving details below
$14.90NZD Quantity



Rebus Bar Un-engraved: Code REBUS-BARRibbon bar
$9.20NZD Quantity



Rebus Bar Engraved: Code REBUS-BARENGRibbon bar - engraved. Enter engraving details below
$25.30NZD Quantity



Member Pin: product code REBUS-LAPELNo office title
$10.90NZD Quantity



Officer Pin with title bar: product code REBUS-LAPELTMaximum 14 characters including spaces, enter engraving details below.
$15.50NZD Quantity



Member Brooch: product code REBUS BROOCHNo office title
$10.90NZD Quantity



Officer Brooch: product code REBUS BROOCHTMax 14 characters including spaces, enter engraving details below
$15.50NZD Quantity



President Medallion: product code REBUS-MED
$37.95NZD Quantity



Life Member Wooden Award Plaque inscribed with your chosen text : product code REBUS-PLAQLMEnter engraving details below
$41.40NZD Quantity



Total

$0.00NZD
Please enter any engraving you require in the appropriate box(s) below.

If ordering MULTIPLE ENGRAVED ITEMS separate each name with a comma.
Engraving for Name Badge with pin (REBUS-BDGP)
Engraving for Name Badge with magnet (REBUS-BDGM)
Engraving for Ribbon Bar (REBUS-BARENG)
Separate multiple engravings with a comma
Engraving for Officer Pin with title bar (REBUS-LAPELT)
Engraving for Officer Brooch (REBUS-BROOCHT)
Engraving for Life Member Award Plaque (REBUS-PLAQLM)
Price listed includes GST but excludes courier fees.

An invoice will be sent to {yourEmail} when the order has been received.

If you require any further information email info@crownbadges.co.nz
Should be Empty:

Rebus Regalia Order Form