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
$

Item # Quant10. Description Price (each pack) Total

#2

Guarding the Flock Note Cards pack of 10 w/envelopes

$5
$

Shipping: 1 = $1.75 each pack of ten $

ORDER TOTAL
$

Item # Quant25. Description Price (each pack) Total

#3

Guarding the Flock Note Cards pack of 25 w/envelopes

$10
$

Shipping: 1 = $2.50 each pack of 25 $

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.


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	$
Item #	Quant10.	Description			Price (each pack)	Total
#2		Guarding the Flock Note Cards pack of 10 w/envelopes			$5	$
Shipping: 1 = $1.75 each pack of ten	$
ORDER TOTAL	$
Item #	Quant25.	Description			Price (each pack)	Total
#3		Guarding the Flock Note Cards pack of 25 w/envelopes			$10	$
Shipping: 1 = $2.50 each pack of 25	$
ORDER TOTAL	$
Ship to:
Name
Street address
City, state & zip
Phone # w/area code
E-mail address

Thank you for your order.


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