ORDER FORM
BETTY THREATT
190 PAMELA DR. S
BROOKELAND, TX 75931
409-698-9802
INFORMATION NEEDED TO COMPLETE YOUR SPECIAL ORDER--PLATE and/or CUP
CHAPTER NAME & NUMBER:________________________________________________________
CITY & STATE ______________________________________________________________________
COLORS REQUESTED (for Border)______________________________________________________
SCRIPTURE (Chapter & Verse)__________________________________________________________
FLOWER & Color ____________________________________________________________________
YEAR Of SERVICE___________________________________________________________________
OFFICERS NAMES & STATIONS
WORTHY MATRON___________________________________________________________________
WORTHY PATRON____________________________________________________________________
ASSOCIATE MATRON_________________________________________________________________
ASSOCIATE PATRON_________________________________________________________________
SECRETARY ________________________________________________________________________
TREASURER_________________________________________________________________________
CONDUCTRESS______________________________________________________________________
ASSOCIATE CONDUCTRESS___________________________________________________________
CHAPLAIN___________________________________________________________________________
MARSHAL___________________________________________________________________________
ORGANIST___________________________________________________________________________
ADAH _______________________________________________________________________________
RUTH________________________________________________________________________________
ESTHER_____________________________________________________________________________
MARTHA_____________________________________________________________________________
ELECTA______________________________________________________________________________
WARDER_____________________________________________________________________________
SENTINEL_____________________________________________________________________________
PLEASE check spelling of all names, copy and send this information with your payment. Contact me with any questions or concerns. Allow 4 weeks for delivery. I look forward to hearing from you. Please make check payable to BETTY THREATT
THANK YOU.
Copy this form and mail with your check to me at the above address. Prices are on the item pages.