| Please print and complete this form, then mail it to: |
Samba Stuff
c/o ubiqx development, uninq. 885 Hague Avenue St. Paul, MN 55104 USA |
Enter the quantity of each shirt type in the boxes below.
| Size | White Short Sleeve | Black Short Sleeve | Black L o n g Sleeve |
|---|---|---|---|
| Small | (out of stock) | (out of stock) | |
| Medium | (out of stock) | (out of stock) | (out of stock) |
| Large | (out of stock) | (out of stock) | (out of stock) |
| X Large | (out of stock) | (out of stock) | (out of stock) |
| XX Large | (out of stock) | ||
| XXX Large | (out of stock) | (out of stock) |
Total short-sleeve: ______ × rate $________ = $_________ Total long-sleeve: ______ × rate $________ = $_________ Samba Stickers: ______ × $1.50 $_______ = $_________ Please Do Not Send Cash! Grand Total $_________
Remember that we're having a clearance sale, so you'll get a Samba Sticker with every T-shirt.
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Mailing Label (please print clearly) Name Address City, State or Province Zipcode or Postcode Country |
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Please make checks payable to Chris Hertel. If you have any questions about |
Please provide your E'mail address and/or telephone number so that we can contact you if there are any problems with your order.
Email address: _______________________________________________ Phone number: _______________________________________________