Medal & Shield Order Form Sport* Sport Coordinator Name* Email* Date required by* DD slash MM slash YYYY Delivery/Collection* I will collect from SSWA I would like these posted to me SSWA will bring to the event I would like to order* SSWA Medals SSWA Shields Size of Shield* Small - $15 each Large - $20 each Quantity - Small* Quantity - Large* Small Shield Text*5 lines per shield with a maximum of 16 characters per line Large Shield Text*5 lines per shield with a maximum of 16 characters per line Type of medal* Gold - $5 each Silver - $5 each Bronze - $5each Antique - $5 each Interstate - $5 each Quantity - Gold* Quantity - Silver* Quantity - Bronze* Quantity - Antique* Quantity - Interstate* Text on medal*Please state what you would like written on each medal. Up to 6 Lines with a maximum of 20 characters per line