Please Print & Fill Out Form and Return with a Check or Money Order to the Following Address:
Casey Motorsports
N 4761 Larry Road
New London, Wisconsin 54961
| NAME:(Please Print)______________________________________________________________ |
| ADDRESS:______________________________________________________________________ |
| CITY:________________________________________STATE_________ZIP:_______________ |
| DAYTIME PHONE:________________________EVENING PHONE______________________ |
| EMAIL ADDRESS:_______________________________________________________________ |
| DESCRIPTION | PRICE | QUANTITY | TOTAL |
| Black Short Sleeve Shirt from Arizona Sport Shirts | |||
Size Small |
$20.00 |
__________ | __________ |
Size Medium |
$20.00 |
__________ | __________ |
Size Large |
$20.00 |
__________ | __________ |
Size XL |
$20.00 |
__________ | __________ |
Size XXL |
$22.00 |
__________ | __________ |
| Size XXXL |
$22.00 |
__________ | __________ |
| DESCRIPTION | PRICE | QUANTITY | TOTAL |
| White Sweatshirt from Arizona Sport Shirts | |||
Size Small |
$30.00 |
__________ | __________ |
Size Medium |
$30.00 |
__________ | __________ |
Size Large |
$30.00 |
__________ | __________ |
Size XL |
$30.00 |
__________ | __________ |
Size XXL |
$32.00 |
__________ | __________ |
| Size XXXL |
$32.00 |
__________ | __________ |
| Please Add $5.00 S&H to your Amount Totals | $5.00 |
| Please Add all Total Amounts + Shipping & Handling | __________ |