Health Ambassador Badge Order
Email *
Name *
Organization *
Delivery Address *
Where will the badges be distributed? (ie. Which migrant worker facilities?) *
Preview of 58mm pin badges
Order the badges by stating the quantity of each language you would like. If none, enter 0.
English *
Enter the quantity of English badges you'd like to order. If none, please enter 0.
Bengali *
Enter the quantity of Bengali badges you'd like to order. If none, please enter 0.
Tamil *
Enter the quantity of Tamil badges you'd like to order. If none, please enter 0.
Chinese *
Enter the quantity of Chinese badges you'd like to order. If none, please enter 0.
Hindi *
Enter the quantity of Hindi badges you'd like to order. If none, please enter 0.
Telugu *
Enter the quantity of Telugu badges you'd like to order. If none, please enter 0.
Burmese *
Enter the quantity of Burmese badges you'd like to order. If none, please enter 0.
Thai *
Enter the quantity of Thai badges you'd like to order. If none, please enter 0.
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