Diabetic key ring Order Form

"Key to Safety" key ring Order Form

To place an order, please print out this form and mail it with your check to:

I.D. Technology, Inc.
117 Nelson Road
Baltimore, MD 21208-1111
Phone : (410) 602-1911 ..eMail : idtech@abs.net


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Name:____________________________________________________________________
Address:_________________________________________________________________
City:_______________________________State:_________Zip:__________________
Email Address:______________________________________________________
Daytime Telephone Number:___________________________________________
STYLE--------------------- QTY --------- PRICE EACH ---------- AMOUNT----
ENGLISH/ENGLISH_____________________________$8.95________________________
ENGLISH/SPANISH_____________________________$8.95________________________
    Sales Tax ( Maryland Residents ONLY) ___$0.54 per Tag _______________
                                      Shipping and Handling _____$3.00___
                                                      TOTAL $____________