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Salina Ortho Gift Bags Order Form

* Indicates required field

Date Ordered: *

Salina Ortho Staff Member's Name: *

Staff phone number (for questions) *

Ship To:

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Any note to attach? *

Choose Items to include *

Yeti-style cup (value $16) Stadium Blanket (value $12) Small cooler bag (value $2) Cooling Towel (value $3) Larger cooler 24 can (value $20) Can cooler/koozie (value $1.50) Stadium cup (value $1.05) Magnetic Alligator clip (value $2) Frisbees (value $1.85) Key chain with light (value $2.25) Canvas tote bag (value $2.25) Luggage tag (value $.85) Small ice pack (value $1.25) Pop sockets (value $6) Flash drives (value $3)

If you would like multiples of any items, note that here: *

Submit

Magnetic Alligator Clip

Soft side personal cooler

Stadium blanket

Stadium plastic cup

Luggage tags

Flash drives

Note--These items have already been purchased and are in storage. Janzen Marketing will assemble your package and mail out. An itemized postage invoice will be submitted monthly. No payment information is to be entered here.

Hours

By Appointment

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