PIPERS GAP RESCUE SQUAD
2014 FIGHTIN' FOR THE CURE T-SHIRTS!

Visit our team page here.

Here's an opportunity for you to support a great cause!
 
ALL profits from the sale of shirts will be
donated to the American Cancer Society!

Cost of the T-Shirts:
On CLEARANCE for only $7.00 each with FREE SHIPPING!!

Sizes available:   Adult S, M, L, XL, 2XL, 3XL
Gildan 100% Cotton Pre-Shrunk T-Shirt

  

T-Shirt Order Form
Accepting Checks or Credit/Debit Cards
 

ENTER QUANTITY DESIRED FOR EACH SIZE

Quantity for size SMALL?

Quantity for size MEDIUM?

Quantity for size LARGE?

Quantity for size X-LARGE?

Quantity for size 2-XL?

Quantity for size 3-XL?

BILLING INFORMATION

Bill to Name (name on credit/debit card): *

Bill to Address: *

Bill to City: *

Bill to State: * Virginia North Carolina Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Washington Washington, DC West Virginia Wisconsin Wyoming --U.S. Territories-- American Samoa Federated States of Micronesia Guam Midway Islands Puerto Rico U.S. Virgin Islands

Bill to Zip: *

Phone (10 digit number): *

E-mail Address: *

SHIPPING INFORMATION (Leave blank if same as billing)

Ship to Name (if different from billing):

Ship to Address (if different from billing):

Ship to City (if different from billing):

Ship to State (if different from billing): Virginia North Carolina Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Washington Washington, DC West Virginia Wisconsin Wyoming --U.S. Territories-- American Samoa Federated States of Micronesia Guam Midway Islands Puerto Rico U.S. Virgin Islands

Ship to Zip (if different from billing):

PAYMENT INFORMATION

Credit / Debit Card Type: * CHOOSE ONEVISAMASTERCARDDISCOVER PLEASE INVOICE ME THE TOTAL AND I WILL MAIL PAYMENT

Credit / Debit Card Number (16 digit number without spaces or dashes): *   (enter all "0's" if paying by check)

Card Expiration Month (2 digit month): * (enter all "0's" if paying by check)

Card Expiration YEAR (4 digit year): * (enter all "0's" if paying by check)

CID (3 digits on back of card): * (enter all "0's" if paying by check)

Verification Code:

Enter Verification Code: *

Your personal and credit card information is sent and secured using a 256-Bit SSL Connection. You can print this order using the button below for your records and you will receive a confirmation using your email address provided above. Your card will be charged $7.00 per shirt ordered. All Relay for Life Shirts:  $7.00 Each FREE SHIPPING!! Please press the submit button one time.

* Required

MAIL-IN ORDERS
For those who prefer to mail in your payment, download the MAIL-IN order form here. 
Follow the directions on the form.

Copyright © 2013 by Pipers Gap Rescue Squad, Inc. All rights reserved.
Revised: 07/20/14 22:08:31 -0400.