General Society of Mayflower Descendants
Founded at Plymouth, Massachusetts 1897



 SHOPPING
 
Ship To: (street addresses only)
Name:
Address:
City/State/Zip:
Phone:
E-Mail:
 Shipping & Insurance Costs:
If Cost of Order Is:Add:
$50.00 or Less$10.00
$50.01 to $150.00$12.50
$150.01 and Above$15.00
Engraving: front of medal - .35 per letter, back of medal - .30 per letter

ITEM NUMBER QUANTITY DESCRIPTION COST
    
    
    
    
    
    
    
    
    
    
  Sub-Total 
  Shipping, Handling, Insurance (See Above) 
  Engraving (See Above) 
  Total 

General Number*Where Are You a Member?*State Number*
   

*Orders must include general, state and state society numbers. Checks, Master Card, and Visa accepted by mail, fax, or phone. Please endorse checks to GSMD. Expect delivery in 4 to 6 weeks.


Credit Card #:
Code on Signature Box (3 numbers):
Name:
Billing Address:
City/State/Zip:		Exp. Date:
Indicate:
Cash
Check
Credit Card
Credit Card, Check or Money Order - Mail to:
Lea Filson, GSMD Insignia Chair
2703 Octavia Street
New Orleans, LA 70115-7051
Nationwide Cell: 504/491-5330
Fax: 504/218-7968
Additional instructions here: (include item number) (Internal
tracking)
PO:
OR:
AP:
TG:
MD:
SD:
     2006
General Society of Mayflower Descendants
Lea Filson, Insignia Chair
504/491-5330		 www.themayflowersociety.com

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