WCBD Accessories Order Form

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Please complete the information below carefully to ensure you receive your merchandise.

The White Coats Black Doctors Founders' Logo represents solidarity, support and excellence in medicine. Now available on a 1" lapel pin or 1.5" clip-on badge reel, medical students, physicians and supporters can choose to show their pride any way they please. Ca$hApp & PayPal (most major credit cards) accepted.

If you would like to order more items than this form allows, please submit an additional order form or contact orders@whitecoatsblackdoctors.org for assistance.

Full Name *

Email Address *

Phone Number *

Please enter your mobile phone number in the following format: 123-555-7890. Note: We may contact you via SMS regarding your order.

Shipping Address *

Please enter street address, city, state & ZIP. Press the enter key on your keyboard for a new line.

Number of Silver Pins *

$15 each.

Number of Gold Pins *

$15 each.

Number of Hats *

6-Panel unconstructed brushed cotton "dad-style" cap with adjustable brass snap buckle closure. $20 each.

Number of Badge Reels *

Now available in black, with secure grip alligator clip. $5 each.

Number of Phone Grips - NEW! *

WCBD Custom LoveHandle Phone Grip, perfect for selfies, gifts, or juggling that latté on the wards! $7 each.

NEW Add-On Item! Removable WCBD Decal *

White vinyl sticker to be proudly displayed on your water bottle, laptop, or car. Microwave & dishwasher safe, with no sticky residue!

Shipping Preference (USPS-- 3-5 business days) *

For an additional $5.00, I would like to receive tracking information when my item ships. I will add $5 to my total below.

Free shipping without a tracking number. Please send an email when my order has shipped.

Order total, in USD *

$15 per pin, $5 per badge reel, $7 per phone grip & $1.50 per sticker. Don't worry, one of our interns will check your math!

Payment Method (Select CashApp or PayPal) *

Click or scan the link of your desired payment method to enter your payment in a new window, then RETURN to this form to complete your order. (No need to wait for a request or charge from us!)

CashApp $WCBDFoundation cash.me/$WCBDFoundation OR scan & press above with your iOS camera, Snapchat (or any QR reader) to pay on your mobile device!

PayPal http://paypal.me/WCBD or scan & press above with your iOS camera, Snapchat (or any QR reader) to pay on your mobile device!

Failure to submit payment with your order may result in your order being delayed, marked incomplete, or canceled.

Because we are student-led, orders may take up to 7 days to process.

Additional Order Comments

Got a question that can't wait? Having trouble? Email orders@whitecoatsblackdoctors.org or text us at 302-564-9223.

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