Order Multiple Certificates

Certificate Information
Certificate Selection:*
Shellback Certificate
Which version of the certificate do you want?*
Tradional version features traditionally clad mermaids.
Revised version is exactly the same, but features more modestly clad mermaids.
- Traditional
- Revised
Quantity and Personalization
Please indicate the number of certificates you will be ordering and attach a list of names for your certificate(s).

If you would like to add rates/ranks please include these in your list. (Additional charge, see price list for details.)

Also, if you would like to add service designations to your certificates (additional .50/each) please include these in your list.
How many certificates are you ordering?
Upload List of Names*
Accepted file types: doc, xls, txt, rtf, pdf, Max. file size: 80 MB.
Ship or Command:*
Add service designation to name:*
- None
- USN
- USNR
- Other
Custom Service Designation:
Location:*

Your Contact Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number*
Email*
Enter Email Confirm Email
Do you have any other comments pertaining to your order?
Billing Contact Information
Use above contact information for billing also?*
- Yes
- No
Billing Name*
First Last
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Billing Details
How would you like to be billed?*
- Online Invoice through PayPal
  Select this option to pay for your order online. We will send you a bill through PayPal within five days after you submit this order form. You do not need to have a PayPal account to use this option; Paypal accepts credit cards. REMEMBER, you will not receive an online bill immediately, but you WILL receive one shortly.
- Bill Me (only for navy ship/command)
  Individual orders must be paid in advance or with a credit card.
- Supply or other Government Purchase Order

Certificate Information