You may fill out the online form below or download and fax it to:
860.610.5740

Any questions, please call Jean @ 860.610.5717
or email rboza@ccmckids.org

"Festival of Stars" by Patients from Medical/ Surgical Floor 6   "Holiday Stocking" by Thomas, age 8 "Winter Fun" by Rachel, age 10

Choose any one verse, or a combination of any two verses.  Customize with your own verse FREE for 100 or more cards! Verse A: Wishing you good health, happiness and hope throughout the seasons. Verse B: May the spirit of the Holiday Season bring you peace and joy. Verse C: In warm appreciation of our association, we extend heartfelt wishes for a joyful Holiday Season and a prosperous New Year. Verse D: A contribution has been made on your behalf to Connecticut Children's Medical Center. Our gift to you.

Fields marked in red are required.


Step 1: Personal Information

First Name:	Last Name:
Company Name:
Street Address: ( No P.O. Boxes )
City:	State: Choose State... AlabamaAlaskaArizona ArkansasCaliforniaColorado ConnecticutDelawareDistrict of Columbia FloridaGeorgiaHawaii IdahoIllinoisIndiana IowaKansasKentucky LouisianaMaineMaryland MassachusettsMichiganMinnesota MississippiMissouriMontana NebraskaNevadaNew Hampshire New JerseyNew MexicoNew York North CarolinaNorth DakotaOhio OklahomaOregonPennsylvania Rhode IslandSouth CarolinaSouth Dakota TennesseeTexasUtah VermontVirginiaWashington West VirginiaWisconsinWyoming	Zip Code:
E-mail Address:		Phone:

Step 2: Ordering Information
Minimum order 25 cards
Price per card includes shipping & handling.
 

Card Choice	Verse(s) Choice (choose any 1 or combine 2 verses)	# of Cards	Price	Total
1. Festival of Stars	A   B   C   D		$1.60	$
2. Winter Fun	A   B   C   D		$1.60	$
3. Holiday Stocking	A   B   C   D		$1.60	$
Additional Holiday Gift for the Children:				$
Custom Imprint on orders under 100 cards ($20.00):				$
Second Color Charge ($40.00):				$
Total:				$

Step 3: Custom Card Imprinting
Free for orders of 100 or more

Name to be printed on inside of cards:

Name & Return Address to be imprinted on envelopes:

Custom Verse

Step 4: Method of Payment

Bill Me Charge my credit card Note: We will call you to get your credit card number - this is not a secure form.

Step 5: Submit Order
Please review your selection above before clicking the submit button below.

* Please Note: If you are not contacted within a week of placing your order,
please call Jean Boza @ 860.610.5717 or email rboza@ccmckids.org