NAPM- Houston Badge Order Form

                 

Please print clearly - you are designing your own badge)

(WHAT YOU WANT TO BE CALLED)

FIRST NAME: ________________________________________________________
                                                                                                   
FULL NAME: ________________________________________________________

C.P.M. /  A.P.P. : _____________________________________________________

COMPANY NAME:_____________________________________________________
 

Please proof read above carefully.

Daytime phone : ____________________________________________________________

Mailing Address: ____________________________________________________________
                      
                           ____________________________________________________________

                           ____________________________________________________________

New Member (no charge for first badge): _________   
Replacement Badge ($8.00 fee):   ______

Please check here if this is a Past President's Badge (Dark Blue): _______

Return this request form to N.A.P.M.-Houston, Inc., via fax 281-494-0822 with credit card
information and expiration date or mail the form with a check payable to : N.A.P.M.-Houston,
Inc., P.O. Box 771203, Houston, TX 77215-1203.

Contact: Ed Wahowski Treasurer;   Email:  edmw1@alltel.net,   Phone: 281-961-8520
NOTE: Allow 4-6 weeks for badge receipt. Badges may be picked up at the registration table at  the next
 regular dinner meeting.