K-ID CARD - order form      Return to Previous Page

Please print and complete the form with the information requested and attach a recent passport size photo.
First Name:  ___________________________________
Middle:  ___________________________________
Last:  ___________________________________
Address:  ___________________________________
City:  ___________________________________
State:  ___________________________________
Zip code:  _____________    County: ____________   Date of picture: ______________
Telephone:  ___________________________________
Date of birth:  ____________    Age: _____       Gender: __ female __ male
Hair color:  ____________    Eye color: ___________   Weight: _____    Height: _____
Blood type:  ____________    Lenses: __ yes  __ no   Native language: __________________

Mother's/Guardian's info

Father's/Guardian's info

__________________________

__________________________
First name:  _____________________________ First name:  _____________________________
Middle:  _____________________________ Middle:  _____________________________
Last:  _____________________________ Last:  _____________________________
Telephone:  _____________________________ Telephone:  _____________________________
Cell./Other:  _____________________________ Cell./Other:  _____________________________
Distinguishing characteristics:  ___________________________________________________________________
Medications:  ___________________________________________________________________
Notes:  ___________________________________________________________________

By signing this form I agree to release the above information to be printed on the photo id card. Forward Computers is responsible to maintain the confidentiality of all submitted information. The above information may be used by Forward Computers to send promotional information regarding child safety products.

First card $7.50 ( including shipping and handling )  ________
Number of additional cards _____ ($6.00 each)  ________
Total  ________

For payment info, please contact us by:e-mail

 
Parent/Guardian signature: Date:
__________________________________ _________________
Print name: ___________________________