Legion of Valor Gift Shop
ORDER FORM

CUSTOMER INFORMATION
NAME:___________________________________________________________
ADDRESS:________________________________________________________
CITY:____________________________________________________________
STATE:___________________________________________________________
ZIP CODE:_________________________________________________________
PHONE:___________________________________________________________
EMAIL:___________________________________________________________

 

ITEM
PRICE
SHIPPING
TOTAL PRICE
QUANTITY
SUBTOTAL
Bolo Tie
$20.00
 +
free
 =
$20.00
 x
_______qty
 =
$______.___
Golf Shirt
Circle Size:
M, LG, XL
$32.00
 +
$4.00
 =
$36.00
 x
_______qty
 =
$______.___
Golf Shirt
Size: XXL
$34.00
 +
$4.00
 =
$38.00
 x
_______qty
 =
$______.___
Denim Shirt
Circle Size:
XS, S, M, LG, XL
$27.00
 +
$4.00
 =
$31.00
 x
_______qty
 =
$______.___
Denim Shirt
Size: XXL
$29.00
 +
$4.00
 =
$33.00
 x
_______qty
 =
$______.___
Belt Buckle
$39.00
 +
free
 =
$39.00
 x
_______qty
 =
$______.___
Baseball Cap
Circle Color:
black, blue
$15.00
 +
$1.00
 =
$16.00
 x
_______qty
 =
$______.___
Blazer Crest
$30.00
 +
$1.00
 =
$31.00
 x
_______qty
 =
$______.___
Lapel Pin
$10.00
 +
free
 =
$10.00
 x
_______qty
 =
$______.___
Patch
$4.00
 +
free
 =
$4.00
 x
_______qty
 =
$______.___

Static Cling Decal
Minimum order of 3

$6.00
 +
free
 =
$6.00
 x
_______qty
 =
$______.___
Each additional Decal
$1.50
 +
free
 =
$1.50
 x
_______qty
 =
$______.___
 
This is a service that exists solely for the
convenience of the Legion of Valor members
and family. All proceeds are used to cover
the cost of obtaining and shipping the items.
   
GRAND TOTAL
_______items
$______.___
   

 INSTRUCTIONS 

1. Print this page from your computer.
2. Fill out the order form - make sure to select your size or color where applicable.
3. Send order form and a check payable to "Dru Knight" for total amount to:

Dru Knight
4800 Durango Pl.
Melbourne, FL 32904-9734

4. If you have any questions please contact:

Dru Knight
Phone: 321-726-3955
Email: druknght@aol.com