SOUTH PARK T-SHIRTS ORDER FORM

 

                       QUANTITY     UNIT PRICE          TOTAL

 

SMALL              ________             15.00              ____________

 

MEDIUM            ________             15.00              ____________

 

LARGE              ________             15.00              ____________

 

1X                      ________             16.00              ____________ 

 

2X                      ________             17.00              ____________

 

3X                      ________             18.00              ____________ 

 

 

SUBOTOTAL                                                         ____________

 

SHIPPING (each)                             5.00                ____________

 

 TOTAL                                                                  ____________

                                                                         

 

SHIP TO: (please print legibly)

 

NAME: ________________________________________________

  

ADDRESS: _____________________________________________

  

CITY/STATE/ZIP ________________________________________

 

 PHONE: ______________________________________________

  

EMAIL: _______________________________________________

 

 

Make checks payable to SPHA

 

Mail order form and payment to:

5799 Western Trail

Beaumont, TX  77713

 

     Home phone:  409/899-1879 

Cell phone:     409/659-6014

Email:   miriamc.nichols@yahoo.com

 

 

                          THANK YOU!