Name of Chapter ________________________________________
Name of Chapter Advisor _________________________________
Signature of Chapter Advisor _______________________________
Name and address of person to whom merchandise should be sent:
Name ________________________________________
Date of Order _____________
Institution
_________________________________________________________________
Address
_________________________________________________________________
(with Zip Code)
__________________________________________________________
E-mail Address
_________________________________________
| Item |
|
Price | ||||||||
| Banners | $50.00 per banner | |||||||||
| Roll Books | $35.00 per book | |||||||||
| Honor Cords | $12 per set if 3 or fewer are ordered; $10 per set if 4 or more are ordered | |||||||||
| Pins | $20.00 per pin | |||||||||
| T-Shirts |
|
$10.00 per shirt | ||||||||
| Printed Constitution and Bylaws | $1.00 per set | |||||||||
| MathAcrostics Booklet | $5.00 per booklet |
Please enter the number of Banners _____ @ $50
= $ ________
Please enter
the number of Roll Books _____ @ $35 = $ ________
Please enter
the number of Honor Cords _____ @ $10 = $ ________
Please enter
the number of Honor Cords _____ @ $12 = $ ________
Please enter the
number of Pins _____ @ $20
=
$ ________
Please enter the number of T-Shirts _____ @ $10
= $ ________
Please enter the
number of Constitutions _____ @ $1 =
$ ________
Please enter the
number of MathAcrostics _____ @ $5
=
$ ________
Total Enclosed $ ________
Mail with check payable to Pi Mu Epsilon to: