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Endorsed Swim School Order Form

* Indicates required field

* Swim School Name
Purchase Order Number
* Delivery Address
Delivery Suburb
Delivery Postcode
* Contact Person
* Contact Phone
* Contact Email

Infant Aquatics

Product Cost Quantity
Certificates with logo overprint $0.05 extra
Certificate — Duck 1 $0.60
Certificate — Duck 2 $0.60
Certificate — Duck 3 $0.60
Certificate — Duck 4 $0.60
Certificate — Duck 5 $0.60
Keep Watch/Infant Aquatics Rubber Duck $2.00

Swim & Survive Certificates

Product Cost Quantity
Certificates with logo overprint $0.05 extra
Stage 1 Progress Report $0.60
Stage 1 $0.60
Stage 2 $0.60
Stage 3 $0.60
Stage 4 $0.60
Stage 5 $0.60
Stage 6 $0.60
Stage 7 $0.60
Stage 8 $0.60
Stage 9 $0.60
Stage 10 $0.60
Stage 11 $0.60
Stage 12 $0.60

Awards — Certificate and Badge

Product Cost Quantity
Certificates with logo overprint $0.05 extra
Dry Rescue $2.50
Stage 13 — Wade Rescue $2.50
Stage 14 — Accompanied Rescue $2.50
Stage 15 — Bronze Star via course request form
Stage 16 — Bronze Medallion via course request form

Junior Lifeguard Club

Product Cost Quantity
Coach’s manual $38.50
Logbook $2.75
Stickers (per sheet) $1.65

Cloth Badges

Product Cost Quantity
Stage 1 $1.85
Stage 2 $1.85
Stage 3 $1.85
Stage 4 $1.85
Stage 5 $1.85
Stage 6 $1.85
Stage 7 $1.85
Stage 8 $1.85
Stage 9 $1.85
Stage 10 $1.85
Stage 11 $1.85
Stage 12 $1.85

Note: Please allow 2 weeks for delivery.

Bulk Order Certificates — Less than 3000 ($0.60), Between 3000–5000 ($0.55), More than 5000, ($0.50)

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