LOGO WEAR ORDER FORM

Please provide the following ordering information:

Please identify yourself:

First Name  Last Name

  Phone No.   Email

Please provide the following product information:

Rock Church Tee

Choose one of the following options:

  Choose Color Orange Green Azalea White

Choose one of the following sizes:

  Choose Size Extra Small Small Medium Large Extra Large

         Choose quantity:

            Select Quantity 1 2 3 4 5 6 7 8 9 10

Payment:
            Select Payment Option Personal Check Credit Card
Credit Card (Please call 540-324-0705 to give CC information)
Personal Check (Mail to: 1156 Tinkling Spring Road, Staunton, VA  24401)

** Orders will be placed upon receipt of payment


Additional Comments: