Juneteenth Tee Shirts Order Form

If using mobile device, hold horizontally for best viewing.

Begin filling in the form below by entering your FIRST AND LAST NAME.

Indicate the count for each size you wish to order.


Small:	XLarge:	4X:
Med:	2X:	5X:
Large:	3X:	6X:

Your Invoice Info

If corrections are needed on invoice -- scroll UP to the Order Form at top and correct the information. Scroll down and Click VIEW OR UPDATE INVOICE again to review the corrected information.

Line	Item	Option	Quanity	Price	Total

Customers will be notified via email address used for payment, when shirts become available.

Your shirts will be shipped by mail to address provided on Shipping Label

Thank you for placing your T-shirt order

date	fname	middlei	lname	address	apt_suite	city	state	zip	unit	membership	phone	email	voter	dateofbirth	installmentCt	appCode	appType	appPrice	appInvoice	appOption

SHIPPING LABEL

Enter Shipping Address

Name:
Address:
Apt:
City,state,zip:
Phone:

Membership Store

*Membership Type:

Num of Installment Payments You Wish to Make

*Name:

*Address:

*City/State/Zip:

Unit:

Contact: *Email:

Registered To Vote:

Form :

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