CHAPTER SUPPLY ORDER FORM - Illinois, St. Charles & St. Louis

BNI Mid America Region

Medici MediaSpace, 2055 Walton Rd, Overland, MO 63114

Date Order Prepared:	01/21/2020
Your Name:
Phone:
*Chapter:
# Members:	# Referrals/Mo.
	We will pick up supplies at our area RSS (no shipping fee) Please ship our supplies ($20 shipping fee)
*All these fields are required:
*Ship To:
Company:
*Address:
*City/State/Zip:	//
*Email:

NOTE: A $20 fee for processing and shipping will be added at checkout.  Please allow 1 week for delivery.
Questions? Email nicolem@bnimidamerica.com or call: 314-822-1030 x0.

CHAPTER SUPPLIES (BOLD = supplies need most)

Item	QTY	# Ordering
Visitor Packets (includes: new member application, visitor information sheet, regional production number, member testimonials and a marketing brochure)	10
Visitor Name Tags	`10
Green "I Have" Report Cards (per pack)	100
Notable Network Certificates	10
New Member Applications	10
Renewal Applications	10
Post Card Invitations	25
Ribbon - Education Coordinator	1
Ribbon - Events Coordinator	1
Ribbon - Growth Coordinator	1
Ribbon - Membership Committee	1
Ribbon - Mentor	1
Ribbon - Mentor Coordinator	1
Ribbon - Power Teams Coordinator	1
Ribbon - President	1
Ribbon - Secretary Treasurer	1
Ribbon - Vice President	1
Ribbon - Visitor Host	1
New Member Success Kits (keep 2 on hand)	Each
# of new members that do not have new member kit	Each

NOTE: PLEASE DO NOT BREAK UP NEW MEMBER SUCCESS KITS TO REPLACE MEMBER BADGES OR BUSINESS CARD HOLDERS.
New Member Success Kits are to be given to new members only - the cost is covered by the application fee.
If you need additional kits for an existing member, please order below.

Note any special instructions:

BNI GIFT SHOP ITEMS

Item	Price	# Ordering	Amount Due
BNI Name Badge (Magnetic)	$5.00
BNI Card Holder - Small	$8.00
Timer Paddle Set	$25.00
Visitor Welcome Board**	$55.00
Chapter Goal Board**	$65.00
Book - The 29% Solution	$10.00
Book - Money on the Table	$17.00
Book - Room Full of Referrals	$17.00
Book - Avoiding The Networking Disconnect	$17.00
Book - Who's In Your Room?	$17.00
Library Starter Pack	$230.00
Additional Member Success Kits	$25.00
Passport To Success	$2.00

Shipping      $

TOTAL DUE      $

**An additional $20 shipping charge will be added for each oversized item.