To order, print this page and mail it along with your check payable to Miami Valley Chapter NCRS to Greg Gorniak, 624 Southern Belle Blvd., Beavercreek, Ohio 45434.
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NAME_________________________
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DATE__________________
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The official club color is Birch and all items will have our Chapter logo. For special requests, contact Special T's at (937) 433-4840.
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ITEM
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SIZE
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PRICE
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QTY.
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AMOUNT
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Polo Shirt (Men's Cut) -Birch
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$40.00
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$
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Polo Shirt (Ladies' Cut) -Birch
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$40.00
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$
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Long Sleeve Denim Shirt
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$30.00
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$
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Short Sleeve Denim Shirt
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$29.00
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$
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Ball Cap - Indicate colors. _________
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$18.00
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$
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Nylon Coach Jacket -Emerald blue
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$40.00
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$
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Three Season Jacket -Emerald blue
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$75.00
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$
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T-Shirt -Birch
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$22.00
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$
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Cooler (12 Pack)-Black
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$30.00
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$
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Straw Hat (Circle band color -white, red or blue)
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$26.00
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$
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Band only (Circle band color -white, red or blue)
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$11.00
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$
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Tote (15" X 16") -Natural/Navy
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$17.00
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$
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Sweatshirt -Blue
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$35.00
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$
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Add First Name ______________
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$ 3.50
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$
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Add First & Last Name ___________________________
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$ 5.50
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$
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Special Instructions:
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TOTAL
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$
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