Order Form for Olean Area Reach Out And Read T-shirt

Name:


Address:

City:

State: Zip:

Email:

Phone:

Ship to address if different from above:

Address:

City:

State: Zip:

Indicate quantity for each size ordered:
@ $13.00 eachChild Large  Adult Small  Adult Medium
 Adult Large  Adult X-Large

@ $15.00 eachAdult XXLarge Adult XXXLarge

Shipping $3.50 on first shirt. $1.00 for each additional shirt shipped to the same address.
Number of shirts at $13.00 × = $
Number of shirts at $15.00 × = $
Shipping total $
Total enclosed $

Orders must be prepaid including shipping. Checks or money orders are accepted. Make payable to Olean Public Library.

Complete form and return to:
Reach Out and Read, Olean Public Library, 134 N. 2nd St., Olean, NY 14760.

Allow 4-6 weeks for delivery.

Olean Public Library 2003. Print button script is written by Eric (Webcrawl@usa.net) for full source code.