ORLAND GRASSLAND SHIRT ORDER FORM

PRINT OUT THIS PAGE, FILL IT IN AND MAIL IT WITH YOUR CHECK MADE OUT TO:

KATHY HAMILTON

17594 CAMBRIDGE PLACE

TINLEY PARK, ILLINOIS 60477

(708) 532-4621

Your name ________________________________________________________

Phone number _____________________________________________________

Number of t-shirts                    ______ @ $8.00     Circle size  S  M  L  XL  2XL  TOTAL $___________

(50 % cotton/50% poly)

Number of long-sleeve              ______ @ $12       Circle size S  M  L  XL  2XL  TOTAL $ ___________

(100% pre-shrunk cotton)

Number of sweatshirts             _______@ $25      Circle size S  M  L  XL  2XL  TOTAL $ ___________

(50% cotton/50% poly)

Number of hats:

            ALL TAN                    ______ @ $5.50                                                    TOTAL $___________

 TAN WITH BLACK BRIM  ______ @ $5.50                                                     TOTAL $___________

TOTAL NUMBER OF ITEMS ORDERED  __________

                                                                          GRAND TOTAL PAYMENT SUBMITTED $_________