Peap-Aca Pins & Year 2016 Award Certificates Order Form
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12016 P
’
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A
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RESIDENT
S
DUCATION
WARDS
ROGRAM
&
2016 A
C
A
P
MERICAN
ITIZENSHIP
WARD
ROGRAM
PEAP-ACA P
& Y
2016 A
C
O
F
INS
EAR
WARD
ERTIFICATES
RDER
ORM
Save $4 on shipping by placing your credit card order online at
Non-Internet orders may require an additional two weeks to process.
Certificate only orders must be placed online. Other orders may also be placed online; or complete this form &
fax it to 412.741.0609, email it to , or mail it to
PEAP-ACA Orders, PO Box 1020, Sewickley, PA 15143-1020; or phone
877.897.4784
for assistance.
BILL-T
A
—
:
SHIP-TO A
(
B
-T
) P
P
O
DDRESS
PLEASE PRINT
DDRESS
IF DIFFERENT FROM
ILL
O
LEASE
RINT
Contact Name: ____________________________________________
Attention: ________________________________________________
School Name: ____________________________________________
Non-PO Box Address: ______________________________________
School District: ____________________________________________
_________________________________________________________
Address:__________________________________________________
_________________________________________________________
_________________________________________________________
City:___________________________________ State: ____________
City:___________________________________ State: ____________
Zip Code:__________ E-mail:_________________________________
Zip Code:__________ E-mail:_________________________________
Phone #:_____________________ Fax #: ______________________
* O
10+ P
(
)
<
& receive a $0.50 per pin discount! > Discounts automatically applied during order processing
RDER
INS
ANY COMBINATION
P
: Credit Card: Amex MC VISA Discover CC# :______________________________Billing Zip _______
AYMENT BY
Cardholder Name: _______________________________________________________ Expiration Date: ____________________
Check—Made Payable to PEAP Purchase Order #:________________________ Signature:_________________________
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Q
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P
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TEM
ESCRIPTION
EFER TO
ROGRAM
LYER FOR
WARDS
ELECTION
RITERIA
UANTITY
NIT
RICE
OTAL
RICE
PRESIDENT’S EDUCATION AWARDS PROGRAM (PEAP)
Elementary School 2016 Excellence Pin—Blue—Large
E
$3.50 ea
$
Middle School 2016 Excellence Pin—Red—Large
M
$3.50 ea
$
High School 2016 Excellence Pin—Black—Large
H
$3.50 ea
$
Excellence 2016 Certificate (For All Students & Grades) - Gold Seal
G
No Charge
Achievement 2016 Pin (For All Students & Grades) - White—Large
W
$3.50 ea
$
Achievement 2016 Certificate (For All Students & Grades) - Silver Seal
S
No Charge
AMERICAN CITIZENSHIP AWARD PROGRAM (ACA)
American Citizenship 2016 Pin (For All Students & Grades) - Large
A
$3.50 ea
$
Sub-Total: $
$
15.00
Standard Ground Shipping/Handling in Continental US for Orders which include Pins = $15:
Certificate
only
orders receive Free Shipping
only
when ordered online at .
Standard Shipping to Alaska, Hawaii & Puerto Rico—Add an additional $17:
$
RUSH Orders—Continental US Only: Add an additional $28—Next Day, or $23—2nd Day, or $15—3rd Day:
$
For International shipping charges, please email for a quotation.
TOTAL: $
Save $4 on S/H by placing your credit card order at: .
These prestigious awards provide individual recognition from the
Office of the President, the U.S. Secretary of Education, and your
NAESP and NASSP for both student achievement & hard work.
2016.1
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