Invoice / order #:____________
Member Induction and
Honor Cord Order Form
* Please include a name and delivery
address. Note: UPS and Fed Ex cannot
deliver to box numbers!
Ship to:
Order completed by:
Phone #:
Member Inductions ($30 one-time fee for each student)
Chapter Name:
(Example:
Zeta Pi Chapter of Lambda Pi Eta at
College/University:
(No abbreviations, example:
Initiation date of students:
(Standard form, example: August 24, 1998 or Fall 2004)
(Please type names
exactly as they should appear on the certificate or attach a list of typed
names to this order)
# First Name Middle Name or Initial Last Name
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Total # of inductees: _______ x $30 per member = $_______
Gold or red and white combination 60” braided cord with tassels
Quantity (#) Gold: _______ Red and White:________
Total # of honor cords: ______ x $8 per honor cord = $ ______
Mail orders to: Lambda Pi Eta, National Communication Association, 1765 N Street, NW,
Member Induction and Honor Cord Order Form
Please
be sure to include:
□
An
induction date
□
Chapter
name
□
Complete
(and/or attached) typed list of names
□
Full
payment, in one check,
payable to NCA. Please do not submit
individual student checks!
Orders will be processed in 4-6
weeks!
May Graduation Orders
For May graduation orders, please submit all required
materials prior to March 30th. Orders received after March 30th cannot be guaranteed!
December Graduation Orders
For December graduation orders, please submit all
required materials prior to October 30th. Orders received after October 30th
cannot be guaranteed!
Payment with a departmental procurement card
Orders may be paid with a departmental credit
card. Please contact
Mail orders to:
Lambda Pi Eta
National Communication Association
1765 N Street, NW