Page 18 - DFCS News Magazine Summer 2013

Circle payment method: Card #:
Description
BLUE Cap - blue patch or white patch
Size Adjustable
Color Price
Qty
$ Due
Name on CC: Signature:
WHITE Cap w/blue patch only
Adjustable 3’ X 5’ 2’ X 3’
Blue patch $15 R,W,B $110 R,W,B $ 85 White $ 35 White $ 38
Exp Date: _________/__________
Polo Shirt - INDICATE Size XXL or XXXL
DFCS Embroidered Patch Blue or White
Name Address
DFCS License Plate Frame
Address
Aviation Bear w/Mini-Medal & Scarf Sheet of DFCS Stamps
50/sheet N/A $ 6 N/A N/A $ 15 N/A N/A $ 28 N/A N/A $7
MC Visa AMX
Discovery
Check
Blue patch or $15 white patch
Tel #: (_________)______________________________________
DFCS Embroidered Patch - Blue only DFCS Embroidered Patch - Blue only
4 1/2”
Blue back- $ 7 ground
SHIPPING ADDRESS
$ 6/ea
City, St, Zip
BILLING ADDRESS IF DIFFERENT FROM SHIPPING
DFCS Gold-rimmed Coffee Mug Authentic DFC Replacement Medal Authentic DFC Ribbon Bar “V” for Valor Device
Set of 2 N/A N/A N/A N/A N/A N/A N/A
Bronze $3 N/A $8 N/A $8
Name
DFC Mini-Medal
Address Address
DFCS Oval Lapel Pin
White $8 Tri-color $ 8 N/A $ 35
City, St, Zip
DFCS Window Decal - No shipping ShippingCosts
Date Received
Amount $ Check #
CC Authoriza- tion
Office Use Only
Upto$10 = $10-$30 = $31-$50 = $ 51 - $100 = $101 & up =
$ 3 $ 6 $ 9 $16 $18
Subtotal. S/H on Subtotal. Stickersand/orDecals. Memorabilia Total. Donation $5 $10 $15 $25 $50 other $_________. Amount Enclosed.
$ $ $ $ $ $
DFC Society Flag
DFC Society Flag
Polo Shirt - INDICATE Size S thru XL
DFCS Coaster - individually
NA
N/A
N/A
N/A N/A $7 N/A Brown $ 18
DFCS Coaster - set of four
$ 20/set Black $ 10
DFCS Logo Key Ring
DFC Ribbon Bar Lapel Pin
DFCS Ladies Lapel Pin
DFCS Member Tie
DFCS Bumper Sticker - No shipping
N/A $ 3.50 N/A $ 3.50
3 1/2”
$ 6
5 1/2”
Blue Back- $ 8 ground