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Special order
                                                                                                  wood-carved
                                                                                                     plaque
                                                                                                 See next page.



                  Name: ________________________________ Date: __________________
                  Email: ________________________________ Phone: _________________
                  Address: _______________________________________________________
                  ________________________________________________________________



                  QUANTITY DESCRIPTION                                        SIZE         TOTAL
                   ____         AFCATCA baseball cap (adjustable) @ $18 each _____        $______


                   ____         AFCATCA Blue Golf Shirts (unisex)             _____       $______
                                 S M L XL                        @ $42 each


                   ____         AFCATCA Challenge Coin           @ $14 each _____         $______


            (Note: Price increases are due to postage increase and increase in costs to the association.)

           Jackets will only be available by special order with a price of approximately $115 depending on the postage, and will
           be sent directly to the purchaser.



                                                   TOTAL OF ABOVE ITEMS:                   $ ________

                                                TOTAL WOOD PLAQUE ORDER ($40 each):       $ _________


                  Donation (Tax deductible within limits of law) Receipt: Yes___ No ___    $ _________

                                                                       GRAND TOTAL         $   _______



                                   POSTAGE AND HANDLING ARE INCLUDED IN ALL PRICES.
                                    MAKE CHECKS OUT TO ‘AF CYBERSPACE & ATC ASSOC’
                             MAIL TO: Bill Cassatt, 1200 Homelife Plaza Apt D-3, Rolla, MO 65401
                                    Phone 573-263-3334      clarkwcassa�@gmail.com





                                 Air Force Cyberspace and Air Traffic Control Association                 33
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