2015 Holiday Card Order Form
On behalf of our patients and their families, thank you for supporting the Barbara Ann Karmanos Cancer Institute’s holiday card program.
Questions, please call Debbie Knowles at 313.576.8102 or email: knowlesd@karmanos.org.
Simply select a card, choose a verse, complete the information and scan or return this form.
Contact Info:
Ship To:
Name: _________________________________________
Name: _____________________________________
Address: _______________________________________
Address: ___________________________________
City: __________________________________________
City: ______________________________________
State: ______ Zip: _______________________________
State: ______ Zip: ___________________________
Phone: (
Phone: (
) __________________________________
(If contact and ship to address are the same, check box)
) ______________________________
Email Address: __________________________________________________________________________________
I would like to order the following:
Card Selection: (circle one)
1 (Grateful Growth - recycled)
5 (Baby Penguin - recycled)
Verse Selection: (circle one)
Quantity:
(Please allow 7-10 working days for delivery):
2 (Iridescent Snowflake)
3 (Holiday Snowflakes)
6 (Trees of Silver - recycled)
C10
W13
C48
7 (Rustic Barn)
W25
or
75 cards @ $2.15 per card
25 @ $2.70 per card
8 (Global Year - recycled)
E34
100 or more __________ cards @ $1.80 per card. One card style.
50
4 (Beautiful Birch - recycled)
One card style.
Order ONLY in increments of 25.
Order ONLY in increments of 25.
One card style per order of 25 cards.
Minimum order is 25 cards.
Imprint: (company name or personal name) __________________________________________________________
(Imprint will appear as listed here. Please reflect caps and lower case letters as desired.)
Card Order Total
$_______________
Imprint Set Up Charge
$
Kwikseal Envelopes
$_______________
6% Sales Tax
$_______________
Handling and Shipping
$_______________
Tax Deductible Donation to KCI
$_______________
GRAND TOTAL
$_______________
Return Address on Envelope
10.00
Yes
No
(Per card style)
($ .11 per envelope)
($17.00 per 25-100 cards; add $2.50 per additional 50 cards)
Thank you for your support!
No charge for adding return address. Will use address listed above.
Check enclosed (payable to: Karmanos Cancer Institute). Please mail order to:
Please charge my:
Visa
MasterCard
Orders must be received
by November 16, 2015
Karmanos Cancer Institute
Attn: D. Knowles – NC06DS
4100 John R
Detroit, MI 48201
AmEx Name on card: ______________________________________________
Card #:___________________________________________________ Exp. Date: ______________ Security Code: _____________
Signature: _________________________________________________ Date: ___________________________________________
You may also scan and email your charge card order to: knowlesd@karmanos.org or call: 313-576-8102.
MICS9108