Merchandise Order Form

Please allow approximately 5 business days for the processing of orders plus time for postage. Please contact mail@pandc.com.au or call 1300 885 982 if you have any questions or require assistance with placing an order.

Name(Required)

First Last

Email(Required)

Phone(Required)

P&C Association Name(Required)

(Please do not use abbreviations)

Delivery Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Select Item(s)

Life Membership Badge

Life Member Quantity (Required)

Price: $ 15.00

Please include all recipients names for life membership badges.

Life Member Recipient Name/s:(Required)

Select Item(s)

Office Bearer Badge - President

President Quantity (Required)

Price: $ 15.00

Please include all recipients names for life membership badges.

President Name/s:

Select Item(s)

Office Bearer Badge - Vice President

Vice President Quantity (Required)

Price: $ 15.00

Please include all recipients names for life membership badges.

Vice President Name/s:

Select Item(s)

Office Bearer Badge - Treasurer

Treasurer Quantity (Required)

Price: $ 15.00

Please include all recipients names for life membership badges.

Treasurer Name/s:

Select Item(s)

Office Bearer Badge - Secretary

Secretary Quantity (Required)

Price: $ 15.00

Please include all recipients names for life membership badges.

Secretary Name/s:

Conference Badges

Conference Badges (6 pack)

Conference Badges (6 pack) Quantity (Required)

Price: $ 20.00

Office Bearer Badges

Office Bearer Badges (6 pack)

Office Bearer Badges (6 pack) Quantity (Required)

Price: $ 20.00

Conference Only

Duck Notebook (ruled)

Duck Notebook Quantity (Required)

Price: $ 10.00

Total

Payment Method(Required)

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name