Name:______________________________________________

 

Address:____________________________________________

 

E-mail or Telephone:__________________________________

 

                                

Circle size desired, and indicate quantity on the line 

S         ______________

M       ______________

 L       ______________

XL     ______________ 

XXL  ______________

 

Amount enclosed: _________________

($15 per shirt plus $5 PER ORDER shipping and handling.)

 

Special instructions: _____________________________________________________________________________