Duplicate Plaque and Certificate Order Form

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Duplicate Plaque and Certificate Order Form Powered By Docstoc
					Please return this completed form with payment to:
S.C. Press Association P.O. Box 11429 • Columbia, SC 29211 Fax: (803) 551-0903

Engraved 1st Place Plaques – $35
Winner: _______________________________________________________________ Newspaper: ____________________________________________________________ Award: ________________________________________________________________

Duplicate Plaque and Certificate Order Form

Winner: _______________________________________________________________ Newspaper: ____________________________________________________________ Award: ________________________________________________________________

2nd and 3rd Certificates – $2
_____ Certificate(s) x $2 = $ ________
Winner: _______________________________________________________________ Newspaper: ____________________________________________________________ Award: ________________________________________________________________ Winner: _______________________________________________________________ Newspaper: ____________________________________________________________ Award: ________________________________________________________________

2nd and 3rd Plaque Bases – $20
_____ Base(s) x $20 = $ ________

Shipping
Contact: _______________________________________________ Address: ______________________________________________ Phone: _____________________ Newspaper: ____________________________________________ City: ________________________ State: ______ Zip: _________

E-mail: __________________________________

Payment – Total Due $________
☐ Check enclosed Bill my: ☐ Visa ☐ Mastercard Name as it appears on card: _____________________________________ Card #: ____________________________________________ Billing address with city, state and Zip: ________________________________________________________________________________ Exp. Date: ______________ Three digit V-code: _________________ Signature: _____________________________________________

All prices include tax and shipping. Orders typically take two to three weeks. Questions? Call Jen at (803) 750-9561 or e-mail jbarclay@scpress.org