Order Form for Official BWC Name Badge

Enlarged to show detail
Actual size: 2.75" x 1.5"

Use this form to order your official Broadmoor Waltz Club name badge.  Badges are worn only by the gentleman and include the names of the gentleman and his lady.  The price is $12 each.

To order your badge, fill in the fields below exactly as you want the information to appear on your badge.  Your email and physical address are required for verification.  To order more than one badge, complete and send a form for each badge to be ordered.  Your names will appear as: John and Jeanne Jones,
or if the last names are different: John Jones and Jeanne Smith

You will be notified when your badge is ready.  You may pick up and pay for your badge at one of the monthly BWC dances.

All fields are required.

City, State, ZIP