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| Name: | ______________________________________________________ |
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| Street Address: | ______________________________________________________ |
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| City, State, Zip: | ______________________________________________________ |
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| E-mail Address: | ______________________________________________________ |
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| Phone Number: | ( ) _________ - _________________ |
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| Quantity & Size: | ______ S ______ M ______ L ______ XL ______ 2XL |
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| Total # of Shirts: ______ X $18 per shirt: $_______________ |
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Please include check or money order made payable to Laura K. Leuter and include "3G Novelty" in the check memo field. Mail this completed form and payment to: 3G Novelty PO Box 145 Burlington, NJ 08016 Orders ship within 3 - 5 business days once payment has cleared. For status updates or any questions or comments, please e-mail us at [email protected].
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