Parchment Presentation Certificate

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					                                                                                                     FORM B


                            GABRIEL AWARD/CERTIFICATE OF MERIT
                                       ORDER FORM


Name: ___________________________________________________________________________________

Title: ____________________________________________________________________________________

Company: ________________________________________________________________________________

Address: _________________________________________________________________________________
(No P.O. Box #'s, please)

City/State/Zip: ____________________________________________________________________________

Telephone: (day) (______)_______________ e-mail: _____________________________________________

A. Duplicate Gabriel Statuettes:

         Reason for duplicate order? ____________________________________________________________

         ___________________________________________________________________________________

         Signature required of person who signed original entry form:

         (X) ________________________________________Title ____________________________________


B. Duplicate Certificates of Merit:

         Reason for duplicate order? _____________________________________________________________

         ____________________________________________________________________________________

         Signature required of person who signed original entry form:

         (X) ______________________________________Title ______________________________________

C. Production Certificates (A parchment-like certificate acknowledging the presentation of a Gabriel award to
   the winning person/organization.):

         Reason for Production Certificate? _______________________________________________________

         ____________________________________________________________________________________

         Signature required of person who signed original entry form:

         (X) ______________________________________Title _______________________________________


                                                                                                    (continued)
Order Recap:

A. Duplicate Statuettes:
               ________ statuette(s) @ $300.00 each                     $ __________________

B. Duplicate Certificates of Merit:
               ________ certificate(s) @ $30.00 each                    $ __________________

C. Production Certificates for Gabriels:
               ________ certificate(s) @ $30.00 each                    $ __________________

D. Total Amount Due:                                                    $ __________________
       (All orders must be pre-paid)



HELP!!!

We cannot fill your order properly without the following engraving/calligraphy information. Duplicate this page
if you have more than one inscription per A, B, or C.

A. Duplicate Statuette Inscription:

        Title of Winning Entry _________________________________________________________________

        Organization/Station ___________________________________________________________________

        Individual (optional) ___________________________________________________________________

B. Duplicate Certificate of Merit Inscription:

        Title of Winning Entry _________________________________________________________________

        Organization/Station ___________________________________________________________________

        Individual (optional) ___________________________________________________________________

C. Duplicate Production Certificate Inscription:

        Title of Winning Entry _________________________________________________________________

        Organization/Station ___________________________________________________________________

        Individual (optional) ___________________________________________________________________



Return this form along with check made payable to “Catholic Academy” to:

                Catholic Academy National Office
                1645 Brook Lynn Dr., Ste 2
                Dayton, Ohio 45432-1944.

				
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Description: Parchment Presentation Certificate document sample