This list supersedes all previous years -- only orders received on current requisition forms will be honored. You will need to print this form, complete it and then send it along with your check to the address below.
Important!! Please make certain that you include the shipping cost listed in the order form below. Your order could be greatly delayed if you do not..
| ITEM | PRICE | QUANTITY | AMOUNT |
|---|---|---|---|
 Large Emblem Medal (Hereditary Membership)† | $160.00 | . | . |
| Miniature Emblem Medal (Hereditary Membership)* | $85.00 | . | . |
| Large Emblem Medal (Associate Membership)* | $160.00 | . | . |
| Miniature Emblem Medal (Associate Membership)* | $85.00 | . | . |
| Emblem Medals 14-16K Gold (3-4 Month Delivery Time) | On Request | . | . |
| Hereditary Replacement Ribbon -Large Medal | $20.00 | . | . |
| Hereditary Replacement Ribbon -Miniature Medal | $20.00 | . | . |
| Officer Neck Ribbon | $20.00 | . | . |
 Hereditary Rosette | $9.00 | . | . |
 Associate Rosette | $9.00 | . | . |
| Officer Rosette (Specify State or National) | $23.50 | . | . |
| Necktie (All Silk) | $34.00 | . | . |
| Bow Tie (All Silk) | $34.00 | . | . |
 Blazer Patch | $20.00 | . | . |
| Certificate of Hereditary Membership (8 1/2" x 11") Worksheet Required * | $25.00 | . | . |
| Certificate of Hereditary Membership (17" x 19") Worksheet Required * | $45.00 | . | . |
| Certificate of Associate Membership (8 1/2" x 11") Worksheet Required * | $25.00 | . | . |
 Official MOLLUS Scarf (9 1/2" x 72") | $45.00 | . | |
 Set of 9 MOLLUS Blazer Buttons | $65.00 | . | . |
| Gold Plated Challenge Coin | $25.00 | . | . |
| ROTC Medal with Ribbon Bar and Certificate ** | $35.00 | . | . |
 Book: Union Blue by PCinC Robert G. Carroon | $25.00 | . | . |
| MOLLUS Note Cards (Pack of 10) | $6.00 | . | . |
| MOLLUS Post Cards (Pack of 10) | $1.00 | . | . |
 Booklet: Prominent MOLLUS Companions | $3.00 | . | . |
| Shipping Costs | No charge items to $10.00 = $5.00 $10.01 to $50.00 = $8.00 $50.01 to $100.00 = $10.00 $100.01+ = $14.00 | . | |
| †Gold plated over Bronze | . | TOTAL | . |
Send Orders and payments to: Joseph Coleman, Ed.D., 85 Beddington Lane, Strasburg, PA 17579-1451.
Check should be made payable to: "MOLLUS Commandery-in-Chief"
Name:______________________________________________, Insignia Number __________________***
Address:_____________________________________________________________________________
City/State/Zip_________________________________________________________________________
Email Address: _______________________________________________________________________
Questions on supplies and orders should be sent to Joseph Coleman at drjtc30@comcast.net
* Certificate Work Sheets may be obtained by contacting Joseph Coleman at drjtc30@comcast.net
** ROTC Certificates are printed with the name of the Cadet/Midshipman and their school and ROTC unit information. Please provide this information if certificates are needed. Please provide as much lead time as possible for printing, mailing and collection of signatures of your Commandery Recorder and Commander
*** If you do not remember your Insignia Number, contact Keith G. Harrison, PCinC at pcinc@prodigy.net
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