PAPAN - Order Form   
                T-Shirt "Champions for Your Health"

                 PAPAN T-SHIRT ORDER FORM

           
Please complete and sent to:
                 Laura Kling
                                 
email (H) LAKRNMSN@aol.com
                                          -- or --
                         USPS (H) 303 Taggart Drive
                                       Greensburg.PA 15601

Name ______________________________________________
Address ____________________________________________
City, State, Zip ______________________________________

Phone (H) _________________  (W) ____________________

Email _______________________________________________

Cost per shirt
            $15.00 plus $3.00 each for shipping/handling

T-Shirt(s)

   Size                  Quantity                  Cost

___M_______         __________            __________

___L_______          __________            __________

___XL______          __________            __________

___XXL_____          __________            __________

                      Add shipping/handling __________

      Total quantity __________    Total  __________


Date ______Check Number _____ Check Amt. ________


              PAPAN thanks you for your order!

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