Order Form

Price List (U.S. Currency)

Item Name

MEDKEY


MEDCASE


DONPCH

Description

"NO BLOOD" Clear Acrylic Keychain

"Medical Directive"
ID CASE

"Donations" Pouch with Zipper

Colors

N/A


Black, Navy, Maroon


Black, Navy, Maroon, Hunter Green

Price

$3.00
each

$5.00
each

$4.00
each

Order Form

Item Name

Color

Qty.

Price

Subtotal

Minimum Order Subtotal: $20.00

*Order Subtotal:

Tax:

Order
Subtotal

$20.00-$99.99

$100.00-199.99

$200.00 and over

USA
Shipping

$5.00

$6.00

$7.00

CANADA
Shipping

$7.00

$8.00

$9.00

*Shipping:

*Total:

Note: CA residents must add 8.5% tax

*Name:

*Address:

*City:

*State:

*Zip:

#Country:

Phone:

E-mail:

Please send e-mail regarding specials or new products available.

Method of Payment*

Cashier's Check

Money Order

Mail Payment and Copy of Completed Order Form to:

The Gift Source
P.O. Box 3241
Antioch, CA 94531-3241

Order will be processed upon receipt of payment in full.
Allow 4-6 weeks for delivery.

Items Marked With An Asterisk (*) Are Required Fields
# All items are available for shipment to United States or Canada ONLY.
All prices shown are in United States currency.

The Gift Source | "NO BLOOD" Clear Acrylic Keychain | "Medical Directive" Leather ID Case | "Donations" Leather Pouch with Zipper | Order Form

To contact us:

Email: source4gifts@comcast.net