Print form and send with your check, money order, or purchase
order number to the Association address.
If you are making your purchase by credit card, you may either
fill in the credit card information on the bottom of this form and submit it as
above, or you may call the Association office and we'll be happy to process your
order over the phone.
| Item |
Color |
Size(s) |
Quantity |
Price/item |
Total |
| Golf shirt |
white |
|
|
25.00 |
|
| Golf shirt |
blue stripe |
|
|
25.00 |
|
| Golf shirt |
green stripe |
|
|
25.00 |
|
| Henley shirt |
white |
|
|
15.00 |
|
| Women's Shirt |
pink, blue, green
or tan |
|
|
25.00 |
|
| Women's Shirt |
blue denim |
|
|
25.00 |
|
| Men's short sleeve |
Blue Denim |
|
|
25.00 |
|
| Cap |
white |
- |
|
10.00 |
|
| Cap |
yellow |
- |
|
10.00 |
|
| Bag |
blue |
- |
|
10.00 |
|
Video: Truck
Trailer Loading Safety |
Indicate English or Spanish |
- |
|
50.00 |
|
| Video: Avoidable
Tradgedy |
English only |
|
|
25.00 |
|
| Shipping & handling: |
|
|
|
Sub total: |
|
| 1
item |
$4.00 |
|
|
|
|
| 2-4 items |
$6.00 |
|
|
S/H (see chart): |
|
| 5-10 items |
$8.00 |
|
|
TOTAL: |
|
NOTE: Orders shipping to PO Boxes are sent
United States mail
Woman's shirts available in S, M, L, and XL.
To:
Pulp
and Paper Safety Association
1370
North Nealon Drive
Portage,
IN 46368 |
| From: |
| Company: |
| Title: |
| Address: (NOTE ~ please
provide a street address ~ we can't ship to P.O. Box) |
| Phone: |
| Do you want FAX confirmation that your order was
received? YES NO
FAX Number, if YES:
Do you want EMAIL confirmation that
your order was received? YES NO
E-mail
Address, if YES: |
| For credit card
purchases:
Circle the card you are using 
Card number: _____________________________________
Expiration date: ___________
Name as it appears on the card:
________________________________________________
Your signature:
_______________________________________________________________ |
Thank
you for your order! |
