Jacket/Shirt Order Form

Print this form out using the "print" function on your browser. Fill it out and submit it via fax or mail to:

North American Embroidery                            Fax: (775) 322-9588
435 Kietzke Lane
Reno, NV 89502

Attn: Karen

Customer Name _____________________________________________________________

Name on article if different than above _____________________________________________

Address __________________________________, (City/State/Zip) ____________________

Phone  (___) ____________ Alternative phone (___) ____________ Fax (____)____________

Sizes available S  M  L  XL  XXL   XXXL (Indicate below)

QTY

ITEMS

SIZE UNIT PRICE TOTAL
  Deluxe Jacket #J753   Navy/Jade   $40.00 $
        With back emblem   $20.00 $
        With name (specify above)   $  5.00 $
  Standard Jacket #JP70   Navy   $28.50 $
        With back emblem   $20.00 $
        With name (specify above)   $  5.00 $
  RVF golf shirt with logo  White   $24.75 $
        With name   $  5.00 $
  RVF golf shirt with logo   Navy   $24.75 $
        With name   $  5.00 $
                                                    TOTAL ----- ---------  
Payment in the amount of $__________is enclosed in the following form:
     Personal Check
     VISA or Master card (only)

     Card #______________________________  Expiration date ____________

     Signature ____________________________________________________