NATIONAL ARMY SECURITY AGENCY ASSOCIATION - JACKET ORDER FORM
Shipping Information
NAME  
STREET ADDRESS  
PO BOX ADDRESS  
TOWN  
STATE AND ZIP CODE  
E-MAIL  
PHONE  
JACKET #1:COLOR YELLOW   SLATE BLUE    
 SIZESMALL   MEDIUM  LARGE  
   X-LARGE  2XL   3XL  
Unit Location (optional two lines under the patch) (please print clearly)
 

 
Additional JacketsCOLOR YELLOW   SLATE BLUE    
 SIZESMALL   MEDIUM  LARGE  
   X-LARGE  2XL   3XL  
Unit Location (optional two lines under the patch) (please print clearly)
 

 

Total number ordered ________ @ $50.00 per jacket (includes shipping) = $______________

Allow 2 - 3 weeks for delivery.

Send order form to:
EVERGREEN DESIGNS
19159 STATE RT 12F
DEXTER, NY 13634
PHONE (315) 782-5896
voice/fax
E-MAIL dgeng@twcny.rr.com
Method of payment:
($25.00 charge for returned checks)
 Check or Money Order
 Credit Card:  Mastercard    VISA  
   Discover        Amer. Express
CARD NUMBER __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
EXPIRATION DATE (MMYY) __ __ __ __