FOC FLORIDA REGION REGALIA


Order Form

Logo Wind Breaker
Number: Size: $45.00 Each
__________ Large __________
__________ X-Large __________
Polo Shirt
Number: Size: $45.00 Each
__________ Red Large __________
__________ Red X-Large __________
__________ Yellow Large __________
__________ Yellow X-Large __________
White Logo T-Shirt
Number: Size: $20.00 Each
__________ Small __________
__________ Medium __________
__________ Large __________
__________ X-Large __________
__________ XX-Large __________
Red Logo T-Shirt
Number: Size: $20.00 Each
__________ Small __________
__________ Medium __________
__________ Large __________
__________ X-Large __________
__________ XX-Large __________
Red Visor
Number: Size: $20.00 Each
__________ One Size Fits All __________
White Crusher Hat
Number: Size: $20.00 Each
__________ One Size Fits All __________
Red Baseball Cap
Number: Size: $20.00 Each
__________ One Size Fits All __________
Red Umbrella
Number:   $20.00 Each
__________   __________
Total
  Total of Order __________


Mailing Address:

Name: ____________________________________________________

Street Address: ____________________________________________

City, State Zip Code: ________________________________________


Print this form and mail it with your check to: Pamela Reinecke
FOC Florida Region, Treasurer
6710 Tanglewood Drive, N.E.
Saint Petersburg, FL 33702
Make check payable to: FOC Florida Region.