| ORDER FORM | |||||
| Qty: | Item | Size | Cost | Shipping | Total |
| Traditional T-Shirt | $15.00 | $4.00/per | $ | ||
| Tank Top T-Shirt (circle one) Male Female | $15.00 | $4.00/per | $ | ||
| Coffee Mug | -NA- | $8.00 | $4.00/per | $ | |
| Coozie | -NA- | $3.00 | $1.00/per | $ | |
| Art Prints: | |||||
| *Print #1: The Little Lighthouse That Could | -NA- | $20.00 | $4.00/per | $ | |
| *Print #2: Sanctuary | -NA- | $30.00 | $4.00/per | $ | |
| *Print #3: Round Island At Sunset | -NA- | $20.00 | $4.00/per | $ | |
| *Print #5: Lord Help Me | -NA- | $45.00 | $4.00/per | $ | |
| *Print #11: Schooner | -NA- | $20.00 | $4.00/per | $ | |
| *NOTE: All of these prints are limited edition. Prior to sending an order to the above address send an email and verify that the print you would like is still available. | |||||
| Total Amount: | $ | ||||
| Your Information (Ship To:) | |||||
| Your Name: | |||||
| Address: | |||||
| City: State: Zip: | |||||
| Phone Number: ( ) Yes, please send me your membership application. | |||||
| Print and fill out form and mail your check or money order for total amount to:RILPS P.O.Box 1034 Pascagoula, MS 39568-1034Make check or money order out to “RILPS”. Be sure to include the name, address and phone number. Also be sure to include the style and size of shirt required. | |||||
Please PRINT OUT this order form,
fill out and mail to RILPS to place your order.