Medallion Engraving Order Form

Engraving orders will not be taken over the phone.
Please allow 1 week prior to picking up and 2 weeks prior to mailing out your medallion.
Please also note that holidays and weekends are not included in the leadtime.

Person Ordering

Telephone Number
E-mail Address
Select the medallion you would like to order:

Fill in what you would like on your medallion order below (a letter, number, period, space or comma is a character):

Name & Last Initial - Maximum 14 Characters

Dry Date

Group Name - Maximum 18 Character

Slogan or Saying - Maximum 17 Characters

Date Medallion Required

How would you like to receive the medallion?
Pickup at Intergroup OfficeCanada Post (Regular Mail)Canada Post *With Tracking

Address Information

Street Address Line 1

Apartment/Unit

City or Town

Province or Territory

Postal Code

Additional Information

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