Name ________________________________________________________________

Address ______________________________________________________________

City __________________________________ State ________ Zip ______________

Daytime Phone ________________________________________________________


DESCRIPTION SMALL MEDIUM LARGE XL XXL XXXL PRICE EACH TOTAL
WHITE SHORT SLEEVE T-SHIRT         ------ ------ $2.00  
WHITE SHORT SLEEVE T-SHIRT ------ ------ ------ ------   ------ $3.50  
WHITE SHORT SLEEVE T-SHIRT ------ ------ ------ ------ ------   $4.00  
TOTAL PRICE