Bible Order Form

Roullet Bookbinders, Inc. – Aviator Log Book Group Order Form – Page 1

Squadron: Phone Number:

Point of Contact: E-mail:

Street Address (no PO boxes please): # Sets Being Submitted: ______

City/State/Zip: Military Branch (Circle One): Navy Marine Corps

PAYMENT INSTUCTIONS:

Payment is due prior to the order being returned. Shipping is not completely known until the order is packed. It is most convenient if you provide a Visa or Mastercard that can be billed at the time of shipping. If this is not possible, we will call you with a total, at which time you can provide the number over the phone, or forward a check.

□ Charge my credit card: ______-______-______-______Expires: ______/______Name on card: House number only of billing address: Zip Code of billing address: 3-digit “V” code (on back of card by signature line):

□ Call me when my order is ready to ship and I will provide payment.

□ Please use expedited shipping to return my order. (If you do not check this box, your order will be returned via Ground UPS service.

Standard imprint format is shown below. Any variations may be subject to additional imprint fees, and should be sketched on a separate sheet of paper.

Spine: Front: Naval Aviators (wings pin here) Flight Log Book First name, middle initial, last name

First initial, middle initial, last name Military Branch

SSN if desired Roullet Bookbinders, Inc. – Aviator Log Book Group Order Form – Page 2 This form may be reproduced and/or edited as needed, but must include all categories listed below. Custom imprint should be sketched on a separate sheet of paper.

Cover Material (Check One) Mount # Log Ribbon Standard Name as it Should Buck- Bonded Genuine Cover Wings SSN if desired Books Marker? Imprint? Appear on Front ram Leather Leather Color Pin? Sent Y / N Y / N Y / N 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15