2017 National Scout Jamboree Carolina Panther Patch Preorder

Form Deadline Monday, April 4, 2017

Name: __________________________________________________________________________ Address: _______________________________________________________ _______________________________________________________ Phone Number: __________________________________________________ If attending National Jamboree - Circle your JAMBOREE Troop Number Troop Number 4329

Troop Number 4330

Crew Number 5350A

If attending the National Jamboree, your flap will be distributed by your Jamboree Scoutmaster once the Carolina Panther patch comes in. If NOT attending the Jamboree, please check here If NOT attending the Jamboree and want your patch to be MAILED to you, please check here If not attending the Jamboree, you will be notified when patches come in to pick up at a future event, unless you request patch to be mailed to you. If you are on Jamboree Staff and want your patch mailed, please check here Patches are $10 each Qty _______x $10 =

$________________

$5.00 shipping

$5.00

Grand Total:

+

$________________

If paying by credit card - Name on card _________________________________________________ Visa / Mastercard / American Express # ________________________________________________ Exp Date ___________________

Security code from back of card ______________

Please mail completed forms to: Catawba Lodge Jamboree Flap 21008 Catawba Ave Cornelius, NC 28031

Make Checks payable to: Catawba Lodge