CPO Package Order Form
Select Package
18" Ships Wheel Creed:
Qty:
$50.00 ea.
Anchor Cutout Coin:
Qty:
$7.00 ea.
CPO Coin:
Qty:
$5.00 ea.
10 x 13 Solid Walnut Creed:
Qty:
$40.00 ea.
Anchor Cutout Coin:
Qty:
$7.00 ea.
CPO Coin:
Qty:
$5.00 ea.
10 x 13 Solid Red Alder Creed:
Qty:
$40.00 ea.
Anchor Cutout Coin:
Qty:
$7.00 ea.
CPO Coin:
Qty:
$5.00 ea.
Contact Info.
* Required Field
Ordered By:*
Command Name: *
Your email address: *
Phone number: *
Shipping Address
Street: *
Apt. #:
City: *
State: *
Zip: *
Credit Card Billing Address (If Different)
Street:
Apt. #:
City:
State:
Zip:
Nametag Information
Note:  Please submit all names in the "List of Selectees" Box at bottom of form.
*Include Rate, Warfare Designator, and Name
(If you have more than one command please specify in the "List of Selectees" box below):
Command Name
(This is how it will appear on tag):
Date you would like on tag:*
(Ceremony Date or Date of Pinning)
List Of Selectees: (Copy and Paste in Box Below)
***Please be sure to include Name/Rate and Warfare Des.***
!!! Please call 800-765-8277 to confirm your order !!!