T-shirt
order form
Print this form and send it along with your check to the
address below.
Description and Pricing
Info. Quantity Ordered X Shipping/Handling Shipping Information: TOTAL Name:
_________________________________________________ Address:
_______________________________________________ Phone:_(
)__________________________________ E-mail_______________________________________ Make your check payable to: Send this form and payment
to: 911T Registry
Size - Circle one
each
Mens
S
M
L
XL
2XL
3XL
$21.00
Womens
S
M
L
XL
2XL
X
$21.00
$2.50
City: _______________________________State______ Zip: ___________ Country:__________
Mike
Lancial 911T
Registry
3029 Georgia Av. S.
St
Louis Park, MN USA 55426