United Daughters of the Confederacy� - Get as DOC

							                                                      Children of the Confederacy®
                                                NON-ENGRAVED INSIGNIA ORDER FORM
                Type or print all information. Multiple items may be ordered on this form. Send one check for total amount.

FOR ADVISOR USE ONLY                                                      DIVISION
VICE PRESIDENT GENERAL                          DATE RECEIVED                             DATE PROCESSED
Ship to                                                                Member Name
Address                                                                Chapter Name
City/ST/Zip                                                            Chapter No.
Telephone                                                              City                                             DIV
E-mail                                                                   MUST INCLUDE $3.50 SHIPPING AT BOTTOM OF FORM
                CofC CHAPTER VICE PRESIDENT                                            CofC DIVISION VICE PRESIDENT
Signature                                                              Signature
Date received                        Date processed                    Date received                       Date processed


                             INSIGNIA                                                                SASHES
QTY       NO.     ITEM                                       Cost       QTY    NO.     ITEM                                         Cost
           1      CofC Membership Pin                        $15.00             50     Division President                HT_____      $ 4.50
           2      Honorary Associate Member Pin              $25.00             51     Honorary President of Division    HT_____      $ 4.50
          3A      Chapter/Division Top Bar (Silver)          $10.00             52     General Officer                   HT_____      $17.00

          3B      Chapter/Division Top Bar                    $16.00            53     Honorary President of General     HT_____       $ 4.50
                  (Silver 1861-1865)
          4A      General Top Bar (Gold)                      $10.00            54     CWND President                    HT_____       $ 4.50
          4B      General Top Bar (Gold 1861-1865)            $12.00

                       PRESIDENT’S PIN                                                              RIBBONS
QTY       NO.     ITEM                                       Cost       QTY     NO.    ITEM                                         Cost
          10      Chapter President’s Pin                    $25.00             60     8” Chapter/Division Ribbon                     $ 1.00
          11      Ex-Chapter President’s Pin                 $25.00             61     16” Chapter/Division Ribbon                    $ 2.00
          12      Division President’s Pin                   $32.00             62     32” Chapter/Division Ribbon                    $ 4.00
          13      Ex-Division President’s Pin                $32.00             62     8” General Ribbon                              $ 2.00
          14      Honorary Division President’s Pin          $35.00             64     16” General Ribbon                             $ 3.00
          15      Honorary President of General Pin          $45.00             65     32”General Ribbon                              $ 5.00
                                                                                       If ordering ribbon ONLY
          16      Ex- President General’s Pin                 $65.00            80                                                     $ 1.00
                                                                                       Shipping and Handling is only $1.00

                       DIRECTORS PINS                                                     MISCELLANEOUS ITEMS
QTY       NO.     ITEM                                       Cost       QTY     NO.    ITEM                                         Cost
          20      Chapter Director Pin                       $30.00              70    Pin Savers (Per Package)                       $ 1.50
          21      Ex-Chapter Director Pin                    $30.00              71    Centennial Pin                                 $20.00
          22      Division Director Pin                      $35.00                    Page Pin
                                                                                72                                                     $30.00
          23      Ex-Division Director Pin                    $35.00                   (Proof required from CofC VP General.)
                                                                                       10-Year Pin
                                                                                73
                                                                                       (Proof required from Membership Director)       $35.00
                    ROBERT E. LEE PINS                                                 Member for Member Pin
                                                                                74                                                     $20.00
                                                                                       (Member for Member Form required)
QTY       NO.     ITEM                                        Cost              75     CofC Unity Pin                                  $25.00
          30      Robert E. Lee Pin (Medal/Certificate)       $30.00
          31      Robert E. Lee Pin (Certificate Only)        $ 5.00

                VICE PRESIDENT’S MANUAL                                    ****MANDATORY SHIPPING AND HANDLING****
QTY       NO.     ITEM                                       Cost       QTY    NO.     ITEM                                         Cost
          40      Vice President’s Manual                     $5.00      1      80     Shipping and Handling                           $3.50

Check # _____________                                     Total Cost of Order Payable to TREASURER GENERAL COFC $____________

          ***** MUST INCLUDE $3.50 FOR SHIPPING PER ORD ER FORM *****

      Official COFC form                                        Form may be photocopied                                   Adopted July 2009