| Name: |
__________________________ |
| Address 1: |
__________________________ |
| Address 2: |
__________________________ |
| City: |
__________________________ |
| State: |
_________ Zip:_____________ |
| Email: |
____________@____________ |
| Phone #: |
(____) _____-__________ |
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KIS
" Get "
T Shirt |
[ ] Large,[ ] X Large Size,[ ] XX Large Size
___ @ $14.75 ea. + $3.50 Shipping and Packaging |
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KIS
" Got "
T Shirt |
[ ] Large,[ ] X Large Size,[ ] XX Large Size
___ @ $14.75 ea. + $3.50 Shipping and Packaging
|
| Total: |
$ _________
(Nebraska residents, add 5.5% sales tax) |
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| Mail To: |
Yeager Supply
Box 504
Hendley NE 68946 |
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| Phone: (308) 265-7466 • Email: sidewinder_sidewinder@yahoo.com |