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Ordered by: Name and address of person placing
order.
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| Address: | ||||
| City: | State: | Zip: | ||
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Ship to: Only if different from "Ordered by"
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| Name: | ||||
| Address: | ||||
| City: | State: | Zip: | ||
| How did you hear about us? | ||||
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Description
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Size
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Qty
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Price Each
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Total Price
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| To The Hoops image on a 100% cotton shirt. White only ...$12.95 | Kids-M | $12.95 | ||
| Kids-L | $12.95 | |||
| Adult-S | $12.95 | |||
| The Wally Szczerbiak image on a 100% cotton shirt. Black only...$19.95 | Large | $19.95 | ||
| Ex.-L | $19.95 | |||
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Shipping and Handling (U.S. deliveries only) |
Sub Total | |||
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orders up to $25.00 = $4.50 |
$85.01 - $105.00 = $10.50 $105.01 - $150.00 = $11.50 $150.01 - $200.00 = $12.50 $200.01 - $350.00 = $13.50 $350.01 and over = $15.50 |
Add Tax | ||
| Shipping & Handling | ||||
| TOTAL DUE | ||||
DO NOT SEND CASH!
Be sure to include shipping and handling. Sorry, we do not accept C.O.D.
Please allow 4 to 6 weeks for delivery.
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Mail to:(Don't forget the form & your check or
money order)
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Email questions & comments to:
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SZCZERBIAK-MAXWELL
P.O. Box 670 Bethpage, NY 11714-0670 |
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If not completely satisfied, return it in
its original condition postage paid within ten days of receipt for a refund
of the purchase. Shipping and handling not refundable.
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