You have chosen the S-155 Custom badge. You may now complete the Text form with your desired text (We will not process an order with the terms Police, Law Enforcement, Sheriff, Constable etc without original signuture department letterhead). You must provide your email address so we can match the text with your badge order.

Once you have completed the text form and submitted same - Please return to the badge order page to complete your purchase. You will pick your color preference of
Gold, Nickel or Duo-tone combination of both colors.

<form method="post" action="http://www.emailmeform.com/fid.php?formid=107347" enctype="multipart/form-data" accept-charset="UTF-8">
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<font face="Verdana" size="2" color="#000000">s-155 CUSTOM BADGE</font>
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 <td><font face="Verdana" size="2" color="#000000">SPACE 1 </font></td>
 <td><input type="text" name="FieldData0" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">SPACE 2 </font></td>
 <td><input type="text" name="FieldData1" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">SPACE 3 </font></td>
 <td><input type="text" name="FieldData2" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">SPACE 4 </font></td>
 <td><input type="text" name="FieldData3" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">YOUR EMAIL ADDRESS </font></td>
 <td><textarea name="FieldData4" cols="60" rows="1"></textarea><br> </td>
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 <td><font face="Verdana" size="2" color="#000000">SPECIAL INSTRUCTIONS </font></td>
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<td id="captcha_table_header_td"class="label" colspan="2"><font color="#FFFFFF" face="Verdana" size="2"><b>Image Verification</b></font></td>
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<td id="captcha_table_img_td" class="captcha" style="padding: 2px;" width="10"><img src="http://www.emailmeform.com/turing.php" id="captcha" alt="captcha"></td>
<td class="field" valign="top"><div><font color="#000000">Please enter the text from the image</font>:<br><input type="text" name="Turing" value="" maxlength="100" size="10">
 [ <a href="#" onclick=" document.getElementById('captcha').src = document.getElementById('captcha').src + '?' + (new Date()).getMilliseconds()">Refresh Image</a> ] [ <a href="http://www.emailmeform.com/?v=turing&amp;pt=popup" onClick="window.open('http://www.emailmeform.com/?v=turing&pt=popup','_blank','width=400, height=500, left=' + (screen.width-450) + ', top=100');return false;">What's This?</a> ]</div>
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<input type="text" name="hida2" value="" maxlength="100" size="3" style="display : none;">
<input type="submit" class="btn" value="Submit Text Form" name="Submit">&nbsp; &nbsp; <input type="reset" class="btn" value="  Clear  " name="Clear"></td>
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</form>Your heavy duty professional grade custom badge has a wallet clip backing affixed to it to allow you to carry with an optional Leather Belt Holder, ID/Badge Case or a Tri-fold credit card Badge wallet.