Kids Order form for purchase

SELECT YOUR ID OPTIONS BELOW
Just For Kids
Prices subject to change. For current pricing and products visit our website.
Pour les prix de nos 10K et 14K Or appelez ou visitez notre site Internet
This ID is for a
Boy
Girl
Age _____
Medical IDs
Save Lives!
CLASSIC
Necklace $19.95
Bracelet $24.95
Free Custom Engraving
Stainless Steel IDs are ideal for outdoor and physical activities. Complete purchase online and get an additional ID for
only $14.95. Customize your ID from an array of styles and
precious metals at www.IdentifyYourself.com
Red
Outline
Red
Outline
Circle Bracelet Length (Stainless Steel Curb Chain is standard and adjustable.)
Measure wrist: 6” 7” 8” Other
DOG TAG
Avec chaîne en billes
Sélectionnez Plaque
Red
Blue
Embossed
Circle Chain Length: 16” 18” 20”
From
$19.95
Sélectionnez Metal
(Plaque et chaîne)
Acier inoxydable $39.95
Argent sterling
$81.95
Doublé d’Or 10K $131.95
ACIER INOXIDABLE FLEX
En bande de silicone $24.95
Choisir longeur: 6” 7” 8”
Choisissez couleur ci-dessous
Empaquette
Vert
Orange Jaune Bleu
Pour 8 couleurs
Pourpre Rose
Noir
Rouge additionnel $5.00
ENGRAVE
(Print Clearly)
Engrave No Name
Name
Diabetes
Hypoglycemia
ADHD
Asthma
Heart Patient
Abnormal EKG
Pacemaker
Hemophilia
Medicines Taken
Hearing Impaired
Cochlear Implant
Cystic Fibrosis
Cerebral Palsy
Allergic To
(to be engraved)
CALCULATE PAYMENT
Medical ID $
Autism
Epilepsy
Vision Impaired
Other (write below)
Other Information
(to be engraved)
(to be engraved)
PAYMENT METHOD
Ck/MO
MC
Visa
Disc
Card No.
OPTIONS
Bundle Pack $
IdentifyYourself.com
SHIP/MAIL TO
1st Class Lettermail $8.00
Expedited Parcel $12.00
Xpress Post $29.00
Name
Most orders processed in 2-3
weeks. For faster processing and
delivery options call or visit our
website. Orders shipped from
the U.S. and may be subject to
additional duties and taxes.
07.25.12 13
Allergies
Diabetes
Asthma
Autism
Exp. Date
SHIPPING & HANDLING
(Must Choose One)
TOTAL
$
Address
City/Province
Postal Code
Phone
E-mail
Mail this with payment to UMID, PO Box 230 Stn A, Etobicoke,
ON M9C 4V3 OR Fax to 866.287.7434. Call Toll Free 1.800.616.3400
Order online at IdentifyYourself.com
NCAK