Close-Out Shirts Order Form

Print this form by selecting your File button; then the Print option. Complete the form; send by US Mail.
The 506th Airborne Infantry Regiment Association (Airmobile - Air Assault)

Close-Out Shirts Order Form

Contact 506th Association Quartermaster Ron Helwig at 717-944-0564 if you have any questions about this Order Form.

Name: ______________________________ Home Phone: _______________________

Address: ____________________________________ City: _____________________

State: _______ Zip Code: ___________ eMail: _______________________________

## a "member" is someone who has paid their 506th Association 2013 Membership Dues.
Quantity	Item	Each (non-members)	Each (members)##	TOTAL COST
ONLY 1 LEFT IN STOCK	Original Polo Shirt (WHITE; XL only)	$32.00	$29.00
	2006 Memorial Jump T-Shirt (BLACK)
	Small	$5.00	$3.00
	Medium	$5.00	$3.00
	XX-Large	$5.00	$3.00
SUBTOTAL				$
Shipping ($5.50 for the 1st item + $3.00 shipping per additional item)

Payment Options (choose one below)
Check Enclosed - Check Number	AMEX	Visa	MasterCard	Discover
Card Number
CVC Number (Code on back of card)
Expiration Date
Card Billing Addres
Card City, State, Zip
Name on Card
Signature
TOTAL AMOUNT ENCLOSED					$

Make your check or money order payable to:
*506th Airborne Infantry Regiment Association (Airmobile-Air Assault)*
Mail this Order Form and your check or money order to:	506th Airborne Infantry Regiment Association
eMail: 506thheadquarters@506infantry.org	950 Glenn Drive, Suite 150, Folsom, CA 95630
*Please allow 4 weeks for delivery.*	Attn: Quartermaster