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Professional Homecare Providers
Fundraiser Order
Form
Name:_________________________________________________
Address:_______________________________________________
City:____________________
State:_______ Zip:_______
Phone:_(___)____________________
Prices: Hoodies
$30.00 (Item # 1)
Long Sleeve Shirts
$17.00 (Item # 2)
T-shirts
$15.00 (Item # 3)
Canvas Bags - Small
$10.00 (Item # 4)
Canvas Bags - Large
$20.00 (Item # 5)
Shipping
$3.00 per item or $4.50 for 3 items or more
Shirt Sizes:
Sm, Med, Lg, XL, XXL, XXXL, (Add $2.00 for each XXXL item)
Shirt Colors
Available:
White, Gray, Tan, Blue, Pink
Logos Available:
RN Registered Nurse, Crinkle Cut (Logo # 101)
RN Registered Nurse, Regular
(Logo # 102)
I Care, RN
(Logo # 103)
LPN, Literally Perfect Nurse
(Logo # 104)
Nurses Call the Shots
(Logo # 105)
Nurses are Patient People
(Logo # 106)
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Size |
Color |
Logo No |
Price |
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Shipping |
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Total |
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Please make
checks payable to PHP and mail this form to:
Fran Meyer, RN
8256 N 52nd St.
Brown Deer, WI
53223 |