Florida Jim Order Form
Print this page, complete in pen, and mail with check to
Florida Jim, 2520 McCormick Road, Southport Florida, 32409
Qty |
Item |
Each |
|
| Trick Hat (Specify Color) | 15.00 | ||
| Tee Shirt - State which one and size (XXL thru XXXXL add $4,00) | 20.00 | ||
| Western Belt Buckle (Graphic # ________) | 20.00 | ||
| Money Clip (Graphic # ________) | 15.00 | ||
| Cup - (Specify, or Graphic #_________) | 12.00 |
||
| Veteran License Plate | 20.00 | ||
| Pioneer License Plate | 20.00 | ||
| Vietnam Veteran License Plate | 20.00 | ||
| Lapel Pin #________ | 6.50 | ||
| One Side Photo Dog Tag | 10.00 | ||
| Two Sided Photo Dog Tag | 15.00 | ||
|
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Sub total |
|||
| Florida Residents add 7% Sales Tax | |||
Add $5.00 Shipping and Handling |
|
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| Total | |||
Special Instructions - Include size of shirts, lettering desired
on hats, cups, and other remarks:
Name: _____________________________________________
Address____________________________________________
City, State __________________________________________
Zip____________