These badges are available for order by teachers only

Application Form for  Badges for Speech & Drama/Public Speaking & Theatre in Action candidates

Name of teacher
Address
Phone No
Email Address

Badges are available in packs of 5  and 10.  Please indicate how many packs of each grade you require.

Individual badges may be purchased for Theatre In Action

Grade	Please tick	Number of packs (pack of 5 or 10)	Total badges
One
Two
Three
Four
Five
Six
Seven
Eight

Speech and Drama badges cost $35.00 per pack of 5 and $70.00 per pack of 10 plus $3.00 postage & packaging per order.  Theatre in Action badges cost $8.00 each plus $3.00 postage & packaging per order. Money must accompany the order.  The badges will be sent to you by courier as soon as possible after order is received.

Enclosed is $...................... in payment for the above.

Please print this form, fill in and send to: Speech New Zealand, P O Box 12-023, Wellington

For office use only:

Date order received _____________Date order despatched______________

By:______________________