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Commemorative and Awareness Patch Order Form

  1. Each patch is $10, with proceeds benefiting a local charity. Patches will be shipped in a flat-rate envelope at a cost of $7.95.

  2. I authorized Leaps PX to charge my credit card for the above specified quantity of patches and $7.95 shipping.

  3. Please contact with any questions.

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  5. This field is not part of the form submission.