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| Print this form and mail with your payment
to: LRMFA Products 62 Communications Drive Laconia, NH 03246 ATTN: B. Magoon |
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Description |
Size |
Unit Cost |
Qty |
Total |
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LRMFA Cap |
N/A |
$15.00 |
. |
$ |
Communications Cap |
N/A |
$15.00 |
. |
$ |
50th Anniversary Gray T-Shirt |
. |
$12.00 |
. |
$ |
LRMFA Blue T-Shirt |
. |
$10.00 |
. |
$ |
T'ee Shirt sizes: small, medium,
large, x-large |
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White Parade Gloves |
$5.00/pr |
$ |
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Glove size: medium,and large |
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Mourning Bands |
N/A |
$1.00 |
$ |
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Sub total: |
$ |
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Shipping: |
$ |
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Total: |
$ |
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Shipping Charges: $00.00 - $15.00 = $4.95 $15.01 - $25.00 = $5.95 $25.01 - $40.00 = $6.95 $40.01 - $55.00 = $7.25 $55.01 - $70.00 = $8.25 |
Please contact
for shipping and handling charges for
Alaska, Hawaii, international shipments, and
orders over $70.00. Special rates apply.
Personal checks must clear prior to shipping |
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Payment accepted by money order, cashiers
check, or personal check. Credit Cards are not accepted.
Thank you. |
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| Ship to: (please print clearly)
Name__________________________________________________________________________ Address________________________________________________________________________ City, State, Zip___________________________________________________________________ Contact phone number(s)___________________________________________________________ |