Lou Wilkinson HD Convention Scholarship Fund
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2004 HDSA National Convention

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My Order

Name:

Address:

City:

State: Zip Code

Email Address:

I would like to order:

of the T-shirt iron on transfers for $3.00 each which includes Shipping & Handling.

The total for the Iron-On Transfers I am ordering is:

In addition I would like to order:

T-shirts for $16.00 each which includes Shipping & Handling.

The total for the T-Shirts I am ordering is:

The grand total value of my order is:

I will mail my check by (Date)

The quote I would like on the iron-on transfer and/or T-Shirt is reflected in the comments section, below. Also include the size [S/M/L/XL] of any T-Shirt orders. [Please remember to include your Pie-In-The Face votes! You get one vote for every $1.00 of this order!]

My check or money order, payable to Sue Leck, is being mailed to:

Sue Leck c/o HDSF
1526 Applegate Dr.
Naperville, Il 60565

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