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-------- ~ENLARGE~ -----------------~March On DC SHIRT~


Pinellas Patriots T-Shirts Order Form

• Small/Medium/Large.........$12.00 Donation
  
• XLarge & XXLarge ............$15.00 Donation
  
• XXXLarge..........................$17.00 Donation

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

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

NAME______________________________________________________


ADDRESS-___________________________________________________

CITY, STATE, ZIP-_____________________________________________

E-MAIL ADDRESS-_____________________________________________

PHONE #-___________________________________________________


NUMBER OF SHIRTS ORDERED_________AMOUNT ENCLOSED $____________

*We will be placing an order on the March 1, 2010 please make sure your payment arrives before that date.
*Payments are non-refundable.
*Please allow 1-2 weeks for delivery.
*Orders must be picked up at Quaker Steak Bike Night on Wednesdays, a General Meeting or at the following address: 8Kathy Haddon - 10561 127th Pl. Largo, FL 33773

Please print this page and send along with check or money order to:

Carmen Coleman
107 E Jersey Avenue
Brandon, FL 33510-3401

Please make checks payable to Carmen Coleman (Pinellas Patriots Treasurer)

!!!!!!!!!!!!!!!!!!NOW AVAILABLE!!!!!!!!!!!!!!!!


-------------------~Enlarge~

SHORT SLEEVE White T- shirt w/black lettering. Not available in XXXL. Same prices as above - $12.00 for S-M-L, $15.00 for XL - XXL

If you want a LONG SLEEVE in white w/black lettering, the cost is $22.00
If you want a LONG SLEEVE in black w/white lettering, the cost is $24.00
Add two dollars for XL/XXL