Online Ordering Area

Welcome to our online ordering area.
Please fill out the form in full as it pertains to your order.
The total appears at the bottom. If you have any questions
please feel free to E-mail us
or give us a call at (801) 465-4313.
This page updated 4/16/2004 Rev (85)
.

Important Notice:
When you place an online order (you MUST use a credit card) you will be faxed a
Security and Order Verification Form (from a live person) which includes a projected shipping date. This is an acknowledgment of your order and your approval to charge your credit card.
Your order will be processed at the time we receive your signed approval.
Your card will be charged at this time. Any cancellations will incur a cancellation fee respective of the order you placed. which range from $10 to $45
See our FAQ's for more information.

Printable Order forms are available for mailing and faxing here.

Printable PDF Order forms are available for mailing and faxing here.

Questions? Go to:

Frequently Asked Questions : Click Here

All Fields in RED are required.
Fields in Green are optional items.
Style#:
PIN#:
Type of Item Ordering:
Quantity:
Base Price
Check If Ordering from Utah
(6.5% Sales Tax)
Regular Order
x1
x2
x4
Double Order (Cards Only)
Quad Order  (Cards Only)
Base Price Total:
Optional Cost Services
Badge# on Shield Card:
$9.00  
Inscription for Crystal Art,
(if desired)		 $95.00
Please fill out this section as you would like to see it
on your Shield Card product.
Organization Name:
Name to be printed on Shield Card:
Title/Rank:
Other, (if not specified above):
Division/Unit:
Misc. Information:
Optional Data:
Street Address:
City, State, & Zip
Area Code/Phone #:
Secondary phone#
Fax Number:
Pager Number:
Cell Phone Number:
E-Mail Address:
PAYMENT SECTION AND AGREEMENT
BETWEEN PURCHASER AND SHIELD CARD AMERICA

This section pertains to your personal payment information.
Purchaser First Name:
Purchaser Last Name:
Purchaser Street Address:
Purchaser Apartment No:
Purchaser City:
Purchaser State:
Purchaser Zip:
Method of Payment:
Card Type:

Card Number:
Expiration Date:
Base Price
Option(s) Price
SubTotal
Tax Rate
Tax $
Total Amount of Purchase in U.S. Dollars: $

E-mail Address (Required):

The issuer of my credit card identified above is authorized to pay Shield Card America the amount shown as Total Amount of Purchase in U.S. Dollars, (above) upon proper presentation thereof. I promise to pay such Total Amount of Purchase in U.S. Dollars amount (together with any other charges due thereon) subject to and in accordance with the agreement governing the use of such credit card.
 By checking this box I agree with the terms as stated.
Special Instructions (if desired)
By clicking the Submit button you are authorizing us to charge the above credit card.

Note: Your credit card will be charged the full price when we receive your order.
Once you approve your veriMail proof and return the signed approval,
your credit card will be charged for any balances due on your order.
Additional VeriMail Proofs are $12.00 each.
Shipping cost is included in the price listed
For additional iformation, and optional services on your order,
please visit the SCA Fact Sheet

©1999-2002-2003-2004 Shield Card America
P.O. Box 58 Payson, Utah 84651
This page last updated 4/16/2004
www.shieldcardamerica.com