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Uniform Order Form
Date
*
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Month
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Day
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Year
23
24
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Role in the Order of Malta
*
Auxiliary
Chaplain
Dame of Malta
Knight of Malta
Provisional
Staff
Volunteer
Location
*
Boise
Colorado
Honolulu
Los Angeles
Monterey
Oakland
Orange County
Phoenix
Sacramento
Salt Lake City
San Bernardino
San Diego
San Francisco
San Jose
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Other
If other, please list city and state where you live
*
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
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Maryland
Massachusetts
Michigan
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Mississippi
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Ohio
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Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands (US)
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces (the) Americas
Armed Forces Europe
Armed Forces Pacific
Army Post Office (U.S. Army and U.S. Air Force)
Fleet Post Office (U.S. Navy and U.S. Marine Corps)
State
Purpose for purchase
*
Lourdes Pilgrimage
Our Lady of Champion Pilgrimage
Our Lady of Guadalupe Pilgrimage
Name
*
First Name
*
Last Name
*
Mailing Address
*
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands (US)
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces (the) Americas
Armed Forces Europe
Armed Forces Pacific
Army Post Office (U.S. Army and U.S. Air Force)
Fleet Post Office (U.S. Navy and U.S. Marine Corps)
State
ZIP Code
Email
*
Phone
*
Women's Pilgrimage Uniforms
Embroidered Veil
This veil has a comfortably formed crown with an embroidered Malta cross. It is held in place with a comb. Two bobby pins and clips are also included to help secure it in place.
$ 75.00
Quantity:
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0
1
2
3
4
5
Veil
This flat, cotton veil ties around the back of your head and can be secured with bobby pins. (not included) You also need to purchase the veil pin to affix to the front.
$ 16.00
Quantity:
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0
1
2
3
4
5
Veil Pin
Red shield insignia for veil.
$ 10.00
Quantity:
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0
1
2
3
4
5
Malta Scarf*
Only used on the Our Lady of Champion Pilgrimage.
$ 40.00
Quantity:
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0
1
2
3
4
5
Men's Pilgrimage Uniforms
Small Beret - 7 (21.5-22")
U.S. Military Inspection Ready Wool Beret in Black. Made to Military-specs, pre-shaven, leather trim w/ no eyelits. Beret patch is not included in the price and needs to be purchased separately.
$ 41.00
Quantity:
--
0
1
2
Medium Beret - 7.25 (22.25-22.5")
U.S. Military Inspection Ready Wool Beret in Black. Made to Military-specs, pre-shaven, leather trim w/ no eyelits. Beret patch is not included in the price and needs to be purchased separately.
$ 41.00
Quantity:
--
0
1
2
Large Beret - 7.5 (23-23.5")
U.S. Military Inspection Ready Wool Beret in Black. Made to Military-specs, pre-shaven, leather trim w/ no eyelits. Beret patch is not included in the price and needs to be purchased separately.
$ 41.00
Quantity:
--
0
1
2
Extra Large Beret - 7.75 (24-24.5")
U.S. Military Inspection Ready Wool Beret in Black. Made to Military-specs, pre-shaven, leather trim w/ no eyelits. Beret patch is not included in the price and needs to be purchased separately.
$ 41.00
Quantity:
--
0
1
2
Beret Patch
Iron/sew on patch for the beret. 1 5/8" x 1 3/4".
$ 15.00
Quantity:
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0
1
2
3
4
5
Sleeve Patch
Iron/sew on sleeve patch. 3 1/2" x 4 7/8".
$ 20.00
Quantity:
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0
1
2
3
4
5
Tie
Black Skinny Solid Color Necktie, 2" Width
$ 15.00
Quantity:
--
0
1
2
3
4
Payment Information
Total Due
*
$
Name on credit card
*
First Name
*
Last Name
*
Billing Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands (US)
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces (the) Americas
Armed Forces Europe
Armed Forces Pacific
Army Post Office (U.S. Army and U.S. Air Force)
Fleet Post Office (U.S. Navy and U.S. Marine Corps)
State
ZIP Code
Credit Card
*
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