Polar Bear Memorial Association
Fundraising Merchandise
ORDER FORM
| Unit Price | Total | |
| Lapel Pin | ||
| Qty: 1 | $6.00 | |
| Additional Qty: _____ | $5.00 | |
| Tee Shirts | ||
Black & White Outline |
||
| Qty ___ Size: Large | $15.00 | |
Qty ___ Size: XL |
$15.00 |
|
Red, White & Blue |
||
Qty ___ Size: Large |
$15.00 |
|
Qty ___ Size: XL |
$15.00 |
|
Tee Shirt Order Shipping |
$5.00 |
|
Grand Total |
SHIP TO:
| Name: | |
| Street Address: | |
| City, State, Zip: | |
| Phone: |
Print out and mail this completed Order Form with payment to me at:
Kathy Canapini
25815 Cunningham Ave.
Warren, MI 48091
Questions? Contact me by phone at (248) 789-0416 or
Make checks payable to "Polar Bear Memorial Association"