Use this form to order replacement Eyes of Kahless and
Please input your Name and E-mail address:
I need to order following awards; Eyes of
, Eyes of Kahless Clusters
Method of delivery shall be;
will pick them up personally. Note: Rex Moffett is making the awards for the
StarFire Region and he lives in Vacaville CA.
I want to
pick them at the next event I attend, which will be;
mail them to the address below; (there is a shipping fee involved).
My Mailing address;
Notes: (also include any
comments about this form - suggestions are welcome
Note: We will verify your order with our records
before the order is processed.
You may not order more awards than you have earned.
Just a note before you submit this
form. There is some validation that is done before this form is sent to
If there is an error you will get an error report. To make a correction DO NOT
use the Return to Form link at the bottom.
Instead use your browser's Back button. This way the data on your form is still
intact otherwise the Return erases your data.