Cub Scout Religious Emblems

Order Form

Price includes shipping

Pack #    Chartered to Person handling Pack order Position Address E-mail address that you check often: Please re-enter your e-mail address: Home Phone: Work Phone: Light of Christ Emblem/Certificate/Patch x $19.00 = $ (if none, specify '00') Light of Christ Parent Pin x $ 7.00 = $ (if none, specify '00') Parvuli Dei Emblem/Certificate/Patch x $19.00 = $ (if none, specify '00') Parvuli Dei Parent Pin x $ 7.00 = $ (if none, specify '00') Total Cost: $ Please note before pressing Submit: Order is not confirmed until emblem application form(s) and payment are received. Make checks payable to: Archdiocesan Catholic Committee on Scouting Please mail payment to: Melvin Hart 8618 Sonneville Houston, TX 77080-3517 E-mail: hartmelvin@comcast.net (713) 462-1464 (This address will display on the next page) Also, please check everything in this page, including arithmetic