Diabetic key ring Order Form

"Key to Safety" key ring Order Form

To place an order, please print out this form and mail it with your check to:

I.D. Technology, Inc.
117 Nelson Road
Baltimore, MD 21208-1111
Phone : (410) 602-1911 ..eMail : support@id-technology.com


. 
Name:____________________________________________________________________


Address:_________________________________________________________________


City:_______________________________State:_________Zip:__________________


Email Address:______________________________________________________


Daytime Telephone Number:___________________________________________



STYLE--------------------- QTY --------- PRICE EACH ---------- AMOUNT----


ENGLISH/ENGLISH_____________________________$7.95________________________


ENGLISH/SPANISH_____________________________$7.95________________________



    Sales Tax ( Maryland Residents ONLY) ___$0.40 per Tag _______________


                                      Shipping and Handling _____$2.00___


                                                      TOTAL $____________