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