DELTA WIRES

Order Form

(print this form and mail it)

 

 

Size

(M,L,XL,XXL)

Color

(Black/white)

Style

(T-shirt or

Tank-top – tanks are

women’s med only)

Quantity

X Price

= Total

 

 

 

 

X $15

 

 

 

 

 

X $15

 

 

 

 

 

X $15

 

Bumper Stickers

(Got Blues?)

 

 

 

X $1.00

 

Plus Shipping

 

 

 

+ $3.50

 

 

 

 

 

TOTAL

 

Note: If ordering bumper sticker only, include self-addressed stamped envelope to avoid shipping charge.

 

 

Ship to:

Name________________________________________

 

Address______________________________________

 

             ______________________________________

 

State________________________       Zip___________

 

 

Ship check or money order only to:

 

DELTA WIRES

5245 College Ave, suite 321

Oakland CA, 94618

 

Thank You for your order and for supporting the Delta Wires!