Eagle Gifts Galore: Photo Poem Thank You Plaque Order Form
EAGLE GIFTS GALORE
2707 S. DESERT FOREST AVE., ONTARIO, CA 91761   Voice: (909) 947-6634
Fax: (909) 947-6666 e-Mail:  egg@EagleGiftsGalore.net     http://www.EagleGiftsGalore.net
PHOTO  POEM  THANK  YOU  PLAQUE  ORDER  FORM

Be sure to fill in ALL the information requested below.  Use your browser's
"Print" feature to print this form, sign it, and Fax or mail it to the address above.

Please do NOT send Credit Card information via eMail.

ORDER  FORM  INSTRUCTIONS
1. Select Plaque Size.      7.Enter your Pack or Troop Number    11. Total your order.
2.Select Brass Color.      8Enter your Council Name.  12.Fill in your contact information.
3.Select Plaque color.*      9. Enter your Personal Message.  13. Fill in payment information.
4. Fill in Date plaque is needed by.    10.Enter Scouts' Names (if applicable).  14. Print Form.
5.Enter your Background Paper choice. **   (See Background Papers pages.)
6. Select Poem.  (See Thank You Poem Plaques page for poem choices & wording.)

*Some background papers look better on certain brass colors, some on other colors.
If you prefer, we can choose the best brass and plaque colors for the background paper you choose.
** Most Background papers are 8.5” by 11”. They must be trimmed to fit 7”x 5” and 6”x 4” plaque openings.
Not all background papers are suitable for trimming. Please call for more information.
Use your browser's "Print" feature to print this form, sign it, and Fax or mail it to the address above.


12” by 15” Photo Poem Plaque (with 7” by 5” Poem)        $ 79.95 Each       Shipping and Handling $ 21.00
  10.5” by 13” Photo Poem Plaque (with 6” by 4” Poem)   $ 74.95 Each   Shipping and Handling $ 14.00
California Residents add 7.75% Sales Tax


PLAQUE INFORMATION
Plaque Size:
Back Plate Brass Color:
Top Plate Brass Color:
Select plaque color:
Date plaque is needed by:   - -
12" x 15" plaques only.
(10.5" x 13" plaques do NOT have a brass back plate.)
   
POEM INFORMATION
 
Background Paper:  
Choose a Poem:   Poem
Pack / Troop Number:
Council Name:  
This information will help us to determine if your leader
has already received the poem you are ordering for him or her.

* * * * * * * * * * * * * * * * * * * * * * * *
ENGRAVING   INFORMATION
Plate # 1 Engraving for Upper Right Brass Plate
This space is usually the Thank You message.
Write your message, and we will space it out
so that it looks nice.

(Don't forget to include the Date of Presentation!)
EXAMPLE:   YOUR  MESSAGE:
In Appreciation
for Your
Many Years
of
Dedicated Service
to
Cub Scouting
and
Pack 161
June 3, 2015
 









Plate # 3 Engraving for Lower Left Brass Plate
This space is usually where the Scouts' names are listed,
but you may put anything here that you wish.

If there are more than 8 names,
attach a second page and add $1.00 per name.
EXAMPLE:   YOUR  MESSAGE:
From the
Scorpions

Michael Turner
Karl Henderson
Marcus Banks
Mitchell Workman
Jonathan Edwards
Cody Michelson
 










If using Scouts' Names, please check for Correct Spelling.

Plate # 2   Personal Message to be Engraved on Long Center Brass Plate
This space is usually where the Leader's name and the Pack or Troop number is engraved.
You may also add an optional third line, such as “World's Greatest Leader”,
“Mentor Extrordinaire”, “Tiger to Webelos Leader”, etc.
EXAMPLE:   YOUR  MESSAGE:
Mark Jameson
Scorpion Den Leader
Pack 161 - Ontario, California
 




ORDER   SUMMARY
12” by 15” Photo Poem     @    $ 79.95   =   $ 79.95
 Add'l. Names   @    $   1.00   = 
Shipping & Handling   @    $ 21.00   =    $ 21.00
Subtotal       = 
Calif. Sales Tax *   @    7.75%   = 
TOTAL  
10.5” by 13” Photo Poem     @    $ 74.95   =   $ 74.95
 Add'l. Names   @    $ 1.00   = 
Shipping & Handling   @    $ 14.00   =    $ 14.00
Subtotal       = 
Calif. Sales Tax *   @    7.75%   = 
TOTAL  
* California Residents only

Billing Address
Name  Home Phone     - -
Address 1 City    
Address 2 State     Zip    
E-Mail Cell/Wk Phone     - -

Shipping Address (if different)
Name           Phone     - -
Address 1     City    
Address 2     State     Zip    
We must have a phone number for the shipping address.

PAYMENT   INFORMATION:
 Check Enclosed
  Please charge my Credit Card
CREDIT  CARD   INFORMATION:
Name on Credit Card:
First NameMiddle NameLast Name
Please make sure that the Billing Address (above) is where the credit card statement is sent.
  Credit Card Type:      Visa     Mastercard     Discover
CREDIT   CARD   NUMBER: EXPIRATION   DATE: SECURITY   CODE:
    (on back of card)
                  
 
 
Signature: ______________________________________________________________________________________