custom military challenge coins T · 877/527-3775 L · 623/266-7705 F · 623/266-7318 sales@eMilitaryCoins.com

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Coin Re-Order Form


Please fill out the following areas below for your reorder. The more areas filled in, the more accurate your order will be. Submitting this form to eMilitarycoins.com does not obligate you to purchase these coins. We will respond as quickly as possible to your reorder. Your Re-order will be sent you by E-mail and our representative will contact you to assure we reordering the correct coin.

*All fields must be filled out before submitting this form.

Name or Point of Contact: Your E-mail Address:

Company or Unit Name:

Last Invoice Number:

Office Phone:

(must be 10 digits)

After Hours Phone:

(must be 10 digits)

Shipping Address same as Billing 

Billing Address:

Shipping Address:

Date Coins needed:
(example: 10 Apr 05)
(Must be a date- no ASAP)

 Shipping Preference:

Coin Size:

 Coin Quantity:

( number fill up to 10,000)

Metal Color:

Color Fill on Coin:

(No limit on colors)

Coin thickness:

(Normal thickness 3mm)

Diamond Wave Cut:
yes No

Diamond Swirl Cut:
yes No

Epoxy Over:

Engraved Numbers:
yes No

Special cut outs on coin :
yes No

 Two Tone Metal Plating :
yes No

Picture Insert on coin :
yes No

Ribbed Edge on coin:
yes No

Make Key Chain from coin:
yes No

 SandBlasted Effect:
yes No

Odd Shape:
yes No

 
Comments:

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Submitting this form to eMilitarycoins.com does not obligate you to purchase these coins.

We will respond as quickly as possible to this estimate request.

Send artwork via email please sales@eMilitarycoins.com
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