
Print and complete this form to order by mail
Silver: $25– X _____ = $_________
Golden Bronze: $5– X _____ = $_________
Oxidized Bronze: $6– X _____ = $_________
All 3 as a Set: $35– X _____ = $_________
* Postage * $________*
Total Order $_________
* Postage = $1.65 per individual medal, $1.75 per two, $2- per three, and $2- per set