Circle the pattern that you wish to order for your banner: and write the name of the emblem here
__________________________________________
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Baptismal
shell
Chalice with
grapes and
bread
Order form for Banner #3
Parent’s Name___________________________________
Child’s Name____________________________________
Home Address____________________________________
Home Phone_______________________________Cell_______________________
E-mail___________________________________________
Parish where child will receive Communion_______________
FAMILY NAME to be embroidered in gold on banner - up to 14 letters and spaces
" __________________________________ "
COLOR OF BANNER - You may select light blue or white ___________________.
NAME OF EMBLEM CHOSEN: __________________________________________
CREDIT CARD: We accept Visa or Master Card only
Name on card_______________________________________
Billing address for card_______________________________________
Zip Code________
Visa or Master Card #__________________________________
Expiration Date___________
Signature____________________________________________
Call in your order to: 914-793-0036
E-mail your order to: thistlesnthings@aol.com
Mail your order to:
Thistles ‘n Things, 221 Scarsdale Road, Crestwood, New York 10707
Fax your order to:
You may fax your order with credit card information to (914)-793-0036

