Penn-Dutch Club Shop Order Form

(please print out, fill in, and mail to the address below with your check made out to PDGPC)


Item # Quant. Description Size Color Price (each) Total
#1

Guarding the Flock T-Shirt


$12
$






$






$






$






$






$
Shipping: 1-3 = $8.25, 4-8 = $15.20, 9-16 = $20.10, 17-20 = $27.05, 21-24 = $34.05 $
ORDER TOTAL
$
Ship to:
Name

Street address
City, state & zip
Phone # w/area code

E-mail address


Please mail completed forms to David Kintsfather, 239 E Weiss St, Topton, PA 19562.
Be sure to include check or money order made out to PDGPC.

Thank you for your order.


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