The Broad Ripple Gazette

Collector Pin Order Form

 

The Broad Ripple Cloisonné Collector Pins are available at many locations throughout the Broad Ripple area.  If you wish to receive mail delivery, please fill out this form and return with payment.

 

                                                                                                                                Date _____________________

 

 

Name

__________________________________________

 

 

Address

__________________________________________

 

 

City, State, Zip

__________________________________________

 

 

phone

__________________________________________

 

 

email

__________________________________________

 

 

Pin Style

Per pin

Total

__ BRV Duck 001

$6

 

__ Canal 002

$6

 

__ BR Gazette 003

$6

 

__ Patio sign 004

$6

 

__ Bagel clock 005

$6

 

__ Vogue marquee 006

$6

 

__ Chelsea’s 007

$6

 

__ Fire station 32 008

$6

 

 

SHIPPING/HANDLING

$3.50

 

SUBTOTAL

 

 

TAX (Indiana residents 7%)

 

 

TOTAL

 


Please mail with payment to:

 

The Broad Ripple Gazette

PO Box 55973

Indianapolis, IN 46205

 

Prices are subject to change without notice

Indiana sales tax is calculated on amount including shipping.

Questions? info@BroadRippleGazette.com   (317) 759-4825