Order Form

Leather or embroidery name tags for flight suits, flight jackets.
Cost per name tag:  $10 each, We will pay all shipping costs

PRINT OR TYPE IN ALL CAPITAL LETTERS!!

Type of wings / service branch insignia? ________________________________


            ____________________________________
                            NAME

           
            _____________       _________________
                RANK            BRANCH OF SERVICE

QTY:  _____ EMBROIDERY  ______ LEATHER 

VELCRO ON BACK?    YES  /  NO
-----------------------------------------------------------------------
IF EMBROIDERY: choose one from each of the following:
wings/insignia:   metallic thread color: Gold / Silver 
               or regular thread color:  Gold / Silver / Black / Other

background color: red____ navy____ OD______ blue_____ green____
                  black_____ other_____________
-----------------------------------------------------------------------

TOTAL NUMBER OF NAME TAGS ______ ( X $10 each ) = ________ (TOTAL COST)

Name:     _____________________________________________________________

Address:  _____________________________________________________________

E-mail:   _____________________________________________________________

Phone:    _____________________________________________________________

Comments: _____________________________________________________________

Send this order form and check to: 
Allyn Hinton    26 Country Creek Dr.,  St. Peters, MO  63376
e-mail:  MarinePatches@aol.com

Thank you for your order and interest.  Your inquiries and comments on
special designs not on this page are always invited.  

Since all tags are custom made, allow 4 weeks for delivery.

SEMPER FIDELIS