Fill out the applicable fields corresponding to the card
layout you have chosen.

Please fill in all fields.  If a field does not apply type "N/A".
***COMPLETE THIS SCREEN ONLY AFTER YOU HAVE
COMPLETED THE PURCHASE OF YOUR ID CARD.***
Emergency Contact List
(8 Names & Phone #'s &
2 Addresses Maximum)
EMAIL Address- In case we have
any questions regarding your order.
Remember to email your photo and logos to
sales@kjnotaryid.com
Customer Information Worksheet
K.J. Notary & I.D.
Keeping Your Identity Safe
P.O. Box 403
Capitola, CA 95010

(831) 295-5968
sales@kjnotaryid.com
Name, Address & Phone#
Hair & Eye Color
Height & Weight:
Job Title:
Agency or Business Name:
Insurance, Doctor or Vet Info:
School Name & Grade:
Student ID#
Badge#
Date oF Hire:
Business or Bail Bonds License:
Date of Birth:
Emergency Contacts:
Medical Information:
Breed of Pet:
K.J. Notary & I.D.