Certificate of Membership
Certificate of Membership
Certificate of Membership
John Smith
Walnut-Finish Plaque
John Smith
Walnut-Finish Plaque
Certificate matted under
clear lucite and mounted on
an attractive 10 x 13
walnut colored hardwood
plaque, providing a classic
look and style.
Certificate Information
Is this gift a purchase?
Yes No
Please print your name exactly as you want it to appear on the Membership Certificate:
_______________________________________________________________________________________
Membership Certificate
Order Form
Contact Information
Name of Person Ordering:__________________________________________________________________
Email Address: ______________________________________ Phone Number:______________________
Is this order being shipped to you?
Yes No
Qty
Plain
Certificate
Qty
Wooden
Plaque
Qty
USA
$25
$45
$75
Canada
$25
$50
$80
Mexico
$25
$55
$85
International*
$25
$70
$100
22 Law Drive,
PO Box 2900
Fairfield, NJ
07007-2900 USA
For faster service, fax
or email credit card orders
to: 1-973-882-1717 or
membership@asme.org
Total
Order Total
Sales Tax**
Grand Total
ASME Membership
Certificates
Glass
Frame