Print out this form and mail to: BCP Jersey, P.O. Box 30235, Philadelphia, PA 19103
Include your payment with form. Make checks payable to
"BCP".
Name____________________________________________________
Address __________________________________________________
City_____________________________State_______Zip Code____________
Phone_______________________________ E-mail_________________________________
I am ordering the style(s) and size(s) indicated below.
Men's Chest Sizes
| XS | S | M | L | XL |
| (34-36) | (36-38) | (38-40) | (40-42) | (42-44) |
Women's Sizes: Bust on top/Hips below
| XS | S | M | L | XL |
| (34-36) | (36-38) | (38-40) | (40-42) | (42-44) |
| (36-38) | (38-40) | (40-42) | (42-44) | (44-46) |
Jersey costs are below. Please add shipping and handling of $3.00 for each
item.
| Type | Cost | Size | Quantity | Total |
| Men's short sleeve | $65 | |||
| Women's short sleeve | $65 | |||
| Mailing/handling | $3 each | |||
| Total Enclosed | --------------- | -----------> | $ |