T-SHIRT ORDER FORM

Name and Contact Details

Date                  _______________________
Name                _____________________________________________________________________ Postal Address _____________________________________________________________________ Postal Code ________________________________________________________________________
Mobile / Phone _____________________________________________________________________
Email _____________________________________________________________________

T-Shirt Order

Color ________

Size:	S           	M           	L           	XL           	XXL           	Total:  		$  	

Color ________

Size:	S           	M           	L           	XL           	XXL           	Total:  		$  	

IPostage	$  	

TOTAL COST OF ORDER  $  	

We will contact you if the t-shirt size/style you order is not currently in stock

Payment

Cash 	Cheque or Money Order 	Visa 	MasterCard

Other: _____________

Credit Card # 	___  ___  ___  ___ - ___  ___  ___  ___ - ___ Cardholder

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___ - ___

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Expires	 	/  	

name	 	

Card holder signature	 	

Office  Use Only
Payment details: Cash ☐ Credit ☐ Cheque ☐ Money Order ☐

Office Person Name  		Receipt No.  	

Payment processed by F&A: ☐ 	Date  	Initials  	  Posted ☐	Date  	Initials