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Pinellas Patriots T-Shirts Order Form

• S/M/L/XL/XXL.........$15.00 Donation
  

-----Size----------Quantity-----------Logo on Front or Back

• Small---------_______---------------________
  
• Medium-------_______---------------________
  
• Large---------_______---------------________
  
• XLarge--------_______---------------________
  
• XXLarge-------_______---------------________

NAME______________________________________________________


ADDRESS-___________________________________________________

CITY, STATE, ZIP-_____________________________________________

E-MAIL ADDRESS-_____________________________________________

PHONE #-___________________________________________________


NUMBER OF SHIRTS ORDERED_________AMOUNT ENCLOSED $____________

*Payments are non-refundable.
*Please allow 1-2 weeks for delivery.
*Orders must be picked up at Quaker Steak Bike Night on Wednesdays or a General Meeting

Please print this page and send along with check or money order made payable to PinellasPatriots.org

Send to:

Carmen Coleman (Pinellas Patriots Treasurer)
107 E Jersey Avenue
Brandon, FL 33510-3401