Fairey Firefly Paraphernalia Order Form

Please fill out the form, and mail it with payment to the following address:

Tim Fries
140 Racquett Drive
Fort Collins, CO 80524

Your Shipping Address:

      Name: 		__________________________________


      Address: 		__________________________________


      City, State Zip:	__________________________________


      Phone:		__________________________________


      Email Address:	__________________________________


Items for Sale:

Name		Size (circle one)	Price	Quantity	Total

T-Shirt		M L XL XXL		$15  x 	________ =	________

Poster		N/A			$15  x  ________ =	________

						Subtotal:	________

						S&H:		________
						($3.95 + 
						$1.00/item)

						Total:		________
    
     
     
     Acceptable Payment: 	Check or Money Order

     Note:	You do not need to add sales tax.