USNA Colorado Parents Club  NAME BADGE FORM The yellow shield name tags that some of us wear are the official badge of the Colorado Parents Club.  They are a handy way to recognize and be recognized by other Colorado parents when you are at events at the Academy.   It also helps Academy personnel recognize you as other than tourists.  In Colorado, they help us to remember names when we are at Parents Club activities.

They are available to Club members at the following costs:

    Pin-type badge:   $15.00
    Magnetic badge:   $17.00

Please complete and mail this form along with your check to:

The Engraving Place
6460 E. Yale Avenue
Denver, CO 80222
Phone: 303-757-3997
Attn: Diane Sinnhold

You may e-mail your order to Diane Sinnhold at:

      office@engravingplace.com


(Please include all information on the form in your e-mail)

PLEASE PRINT

First Parent Name: (First) ___________________ (Last)___________________

Second Parent Name: (First)__________________ (Last)__________________

Mailing Address:_________________________________________________

        ___________________________________________________

        ___________________________________________________


Phone number:________________________

Midshipman’s Name:(First)__________________ (Last)___________________

Class of ________________


Or, if you are not a parent, your relationship to Midshipman:_________________

INCLUDE SHIPPING: $2.50 and TAX (7.6% Denver; 4.1% outside Denver) No shipping charge to pick up at store