| Please mail this form to: | Debbie Rahmer | ||||||
| PO Box 193 | |||||||
| Salfordville, PA 18958 | |||||||
| Make checks payable to Kevin Gobrecht Memorial Fund | |||||||
| Merchandise will be sent to address on check unless noted otherwise | |||||||
| Quantity | Description | price | total | ||||
| G-Man Hat | $15.00 | ||||||
| G-Man Sticker | $3.00 | ||||||
| Koozies |
$3.00 or 2@$5.00 |
||||||
| 2008 G-Man Shirt (Gray Shirt) | $20.00 | ||||||
| G-Man Shirt (White Only) (Small Only) |
$20.00 | ||||||
| G-man
Memorial T-shirt (Adult XXL only.) |
$10.00 | ||||||
| Memorial Photo & Fact Sheet | $1.00 | ||||||
| shipping | add $2.00 for orders less than $10.00 | ||||||
| add $5.00 for orders $10.00 or more plus $3 per shirt | |||||||
| Total | |||||||