LRMFA ORDER FORM

 
Print this form and mail with your payment to:

LRMFA Products
62 Communications Drive
Laconia, NH 03246

ATTN:  B. Magoon

 

   
Description
Size
Unit Cost
Qty
Total

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
White Parade Gloves
$5.00/pr
$
Glove size: medium,and large
Mourning Bands
N/A
$1.00
 
$
Sub total:
$
Shipping:
$
Total:
$

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

Payment accepted by money order, cashiers check, or  personal check. Credit Cards are not accepted. Thank you.
Ship to:  (please print clearly)

Name__________________________________________________________________________

Address________________________________________________________________________

City, State, Zip___________________________________________________________________

Contact phone number(s)___________________________________________________________