Order Form
Retired Firefighter's Association
Bullion Badge
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Order Form Retired Firefighter's Association Bullion Badge
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This is a picture of my badge. Please print, in the space provided below, the wording for your badge.
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Example: |
Mailing information |
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Joseph C. Healy Retired Firefighter's Association Washington D.C. Fire Department |
Name:_______________________________ |
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Please display the way you want your badge to look. |
Address:______________________________ |
| ________________________________________ | _____________________________________ |
| ________________________________________ | _____________________________________ |
| ________________________________________ | Phone:________________________________ |
| ________________________________________ |
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(A fourth line is available for an extra $2.00) |
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Please make your $35.00 check payable to " Joe Healy" |
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(Please state on check "RFA badge") and send to: |
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Joe Healy 7511 Woodville Road Mt. Airy, MD 21771-9209 |