Moline Class of 1969 Homepage

Class of '69 Order Form

Qty	Description	Size	Cost	Total
________	T-Shirt	_________	$12.50 each	_________
________	Sweatshirt	_________	$24.00 each	_________
________	Mock Turtle	_________	$25.00 each	_________
________	Polo	_________	$27.00 each	_________
________	Baseball Cap	_________	$16.00 each	_________
________	Engraved Rock	_________	$25.00 each	_________
			Shipping	_________
			Total	_________

_________ I want to pick up my order at the reunion

_________ Ship my order to: (add $7.50 to your total)

Name:

Address:

City, State, Zip:

______________________________

To order items please print out this form, fill it out, and send with check payable to:

MHS Class of 1969
c/o Connie Dodson
1803 55th Street Place
Moline, IL 61265