Mon Valley Push Merchandise Order Form

Item
Price
Qty
Color (Tees)
Size
Total
'Murphy's Law' cd
$10
       
'REALITY' cd
$12
       
T-shirt
$10
   
Child
 
T-shirt
$10
   
S
 
T-shirt
$10
   
M
 
T-shirt
$10
   
L
 
T-shirt
$10
   
XLG
 
T-shirt 2XXL
$12
   
2XXL
 
Hat
$10
       
Bandana
$8
       
Water Bottle
$1
       
Towel
$8
       
Shipping
$2.00
TOTAL
 

Please fill out the form, and mail along with check or money order to:

Frank Stetar
683 Pike Run Drive
Daisytown PA 15427

Please add $2.00 for shipping and handling.

Please fill out your shipping address:
Name_________________________________________________
Address________________________________________________
City__________________________State_________Zip_________