| Name | First | Last | |||
| Address | Street | ||||
| City | State | Zip | |||
| Daytime Phone | Cell Phone | ||||
| Item Description | Size | Color | Unit Price | Quantity | Total Price |
| Flag: Single side 3'x5' | 145.00 | ||||
| Flag: Double side 3'x5' | 285.00 | ||||
| Flag: Double side 3'x5' with Fringe | 365.00 | ||||
| Short Sleeve T-Shirt w/Lipan Shield | S | White | 22.00 | ||
| Short Sleeve T-Shirt w/Lipan Shield | M | White | 22.00 | ||
| Short Sleeve T-Shirt w/Lipan Shield | L | White | 22.00 | ||
| Short Sleeve T-Shirt w/Lipan Shield | XL | White | 22.00 | ||
| Short Sleeve T-Shirt w/Lipan Shield | XXL | White | 22.00 | ||
| Short Sleeve T-Shirt w/Lipan Shield | XXXL | White | 22.00 | ||
| Bumper Sticker | 2.50 | ||||
| Red/White Cap w/Lipan Shield | 14.00 | ||||
| Coffee Mug w/Lipan Shield | 12.00 | ||||
| Koozie w/Lipan Shield | 4.50 | ||||
| Sub-total | |||||
| Texas residents add 8.25% | |||||
| Shipping & Handling (see below) | |||||
| Total Amt | |||||
|
Shipping is via US Mail Shipping and Handling Rate..... $4.00 for first item $1.00 for each additional item Complete order and mail with payment (check or money order) to: |