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



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



Total number ordered ________ @ $28.00 per shirt (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:
Credit Card: Mastercard VISA
CARD NUMBER __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
EXPIRATION DATE (MMYY) __ __ __ __