Kersey Eagles Shop

NAME

ADDRESS

PHONE NUMBER

EMAIL ADDRESS

CELL PHONE NUMBER

ITEMS

Tee Shirt - $10.00
Camouflage tee shirt - $12.00
Hooded sweatshirt - $20.00
Camouflage hooded sweatshirt - $25.00
Hat - $10.00
Black multi pocket tote bag - $6.50
Black fleece blanket - $27.50
Black koozie - $4.00
Camouflage koozie - $4.00
Black tumbler mug - $16.00
Set of two tumbler mugs - $30..00
Stainless steel thermos - $12.50
Black aluminum license plate - $8.00
White aluminum license plate - $8.00
White plastic license plate cover - $3.00
F.O.E. dish set - $5.00
Pin - $2.50
F.O..E. keychain - 10.00

DELIVERY METHOD

Pick Up - No Fee
Mail Delivery - $ 6.00 Shipping Cost / Item
Shipping - $ 4.00 Shipping Cost / Item

SIZES AND ANY OTHER REQUEST

TOTAL SHIPPING COST

NUMBER OF ITEMS AND TOTAL AMOUNT DUE

DONATE $2.00 FOR HOMELESS VETS

Yes
No

DONATE $2.00 FOR JUVENILE DIABETES

Yes
No

MAKE A DONATION TO THE CLUB

Yes
No

TOTAL AMOUNT DUE

METHOD OF PAYMENT

Pay Pal
Credit / Debit Card
Pre Paid Debit Card
Kersey Eagles Gift Card

TERMS AND AGREEMENTS

Have read and understood terms and agreements
Have not read terms and agreements
Do not understand terms and agreements

AGREE TO TERMS AND AGREEMENTS

Yes
No

AUTHORIZATION FOR ORDER AND PAYMENT

NAME BIRTHDATE DATE OF ORDER

ELECTRONIC SIGNATURE