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INSTRUCTIONS


Use this form to order
MaMHCA Signature Products
by mail. If you want to order
online with a credit card right
now, use the Online Products Order Form.

If ordering the Certificate,
enter your First Name and
Last Name in the SHIP-TO
section exactly as you want
it to appear on the certificate.

Send a check or money order to:

MaMHCA Display Products
17 Cocasset Street
Foxboro, MA 02035 

For deliveries in Massachusetts, add 6.25% for tax.

1) Total your products.
2) Multiply the total by 1.625 to get the order total.
3) Write a check in the amount of the order total, and mail to the address above. Please include all the information required on the form for fastest processing.

 

 
 
MaMHCA Products
MAIL IN ORDER FORM
 
Bill-To Information Fields with an asterisk (*) are required.
First Name:*
 _______________________________
Last Name:*
 _______________________________
Address:* _______________________________
City, State, Zip:* _______________________________
Phone:* _______________________________
Email:* _______________________________
   
Ship-To Information Check if your Ship-To is the same as the Bill-To
First Name:*
 _______________________________
Last Name:*
 _______________________________
Address:* _______________________________
City, State, Zip:* _______________________________
Phone:* _______________________________
Email:* _______________________________
   
About You  
Degree: _______________________________
License #: _______________________________
   
Item Price Qty Subtotal Color
MaMHCA T-Shirt $10.00 ____ $ _______
Burgundy Navy Teal
MaMHCA Tote  $10.00 ____ $ _______  
MaMHCA Signature Mug $10.00 ____ $ _______
MaMHCA Membership
Certificate (Frame not included)		 $15.00 ____ $ _______
Merchandize total $ _______
MA Sales tax
 $ _______ (6.25%)
Order Total $ _______