Please print this order form. Fill out and mail or fax to: Dean Vollmar c/o ParentSafely.com 10488 Secor Road Temperance, MI 48182 Fax: 734-854-7783
Please indicate the desired text for each line: (Note: If you choose not to use all of the lines, please leave them blank and we will increase the type size accordingly to fill the entire magnet.)
Example: BABY JANE DOE Jonathan Doe (Office)......................666-1212 Elizabeth Doe (Office).......................555-2222 Jonathan Doe (Cell Phone)...............666-1212 etc. etc.
1) Child's Name:_____________________________________Background Color________ All Caps?__________ (Child's name will be located at the top of magnet in large text.) 2) EMERGENCY...............................................911 3) _______________________________________________________Bold Text?______ 4) _______________________________________________________Bold Text?______ 5) _______________________________________________________Bold Text?______ 6) _______________________________________________________Bold Text?______ 7) _______________________________________________________Bold Text?______ 8) _______________________________________________________Bold Text?______ 9) _______________________________________________________Bold Text?______ Payment: O Check or money order enclosed. O MasterCard O Visa Card Number___________________________________________Exp.__________ Billing Address: Name________________________________________________ Street Address_________________________________________ City__________________________State____Zip_____________ Phone Number_________________________________________ (Optional, in case we have a question regarding your order.) Email address_________________________________________ Shipping Address: Name________________________________________________ Street Address_________________________________________ City__________________________State____Zip_____________ Total amount including tax and priority sipping for 10-magnets = $9.95 Please mail a Check or Money Order with this form, payable to: "ParentSafely.com"
Mail or fax to: Dean Vollmar c/o ParentSafely .com 10488 Secor Road Temperance, MI 48182 Fax: 734-854-7783Home