Fleetwood MotorHome Association Name Badge Order Form

Please clearly print the words as they are to appear on the badge.

First Name: _____________________          Last Name: ______________________

Spouse or Partner Name: _______________________________________________

City, State of Residence: __________________________________

FMA #: ___________________                      

Name Badge is White Background with FMA Color Logo and Black Lettering

______ Badges with Magnet Backing @ $11.00 each:                     $____________

             (Do Not Use With Pacemakers)

______ Badges with Optional Pin Backing @ $8.00                         $____________

Shipping @ $1.00 per badge ($5.00 maximum):                                $____________

            Total Enclosed:                                                                       $____________

Ship to:            Name: ___________________________________________________

                        Address: _________________________________________________

                        City: _________________________ State: _______ Zip: ___________

                        Phone#: __________________________________________________

Please enclose check or money order payable to:  Badges “R” Us

Mail to:            Badges “R” Us

                        411 N. 6th St. #2444

                        Emery, SD 57332

We accept Credit Cards.

Questions:  Call (760) 212-0682 or email badgesrus@aol.com