(Please type or print)
Ship to:
Name ______________________________________
Address ____________________________________
Address #2 __________________________________
City _______________________________________ State ______ Zip __________
*Orders are shipped via UPS. Please give street name and number, not P.O. Box or Rural Route number.
| Quantity | Cat. Nr. | Description | Price | Amount Due |
| _________ | J1 | Official JCL Patches | $0.25 | $ _________ |
| _________ | J2-C | Clasp Pins | $1.10 | $ _________ |
| _________ | J2-L | lapel pin | $2.15 | $ _________ |
| _________ | J3 | JCL Pencils-sold in dozens | $2.15 | $ _________ |
| _________ | J4 | JCL Award Key | $4.95 | $ _________ |
| _________ | J5 | JCL Charm | $2.15 | $ _________ |
| _________ | J7 | Notebook Stickers | $0.25 | $ _________ |
| _________ | J8 | Automobile Stickers | $0.20 | $ _________ |
| _________ | J10-G | JCL Key Ring (Gold) | $5.00 | $ _________ |
| _________ | J10-S | JCL Key Ring (Silver) | $5.00 | $ _________ |
| _________ | J10-B | JCL Key Ring (Bronze) | $5.00 | $ _________ |
| _________ | J11 | JCL Pen/Highlighter | $2.50 | $ _________ |
| Total Due for Accessories | $ _________ |
| Deduct 20% Member Discount | $ _________ |
| Subtotal | $ _________ |
| Postage and handling** | $ _________ |
| Total Amount Due | $ _________ |
**Postage and Handling. On Orders totaling:
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