Cacti PX

Print the Printer Friendly version of this form and indicate the items you wish to purchase. Then send the printed form and your payment to Joe Henderson at the address below.

Name  (First,  Last):  _________________________________________________
Street Address:  _____________________________________________________
City: ___________________________  State: __________   Zip:   _____________
Phone number: ______________________________________________________


Items and Price List

    Item Price Quantity Cost
  Assn. Golf/Polo shirt $25.00 ________ ________
  Assn. T-shirt $20.00 ________ ________
  Assn. Coffee Mug $10.00 ________ ________
  Assn. Baseball Hat $10.00 ________ ________
    Black Beret $10.00 ________ ________
  35th Regt. Coin $10.00 ________ ________
    Dog Tags $8.00 ________ ________
  Assn. Patch $5.00 ________ ________
  CIB or CMB Lapel Pin $5.00 ________ ________
  CIB $5.00 ________ ________
    35th Regt. Patch $5.00 ________ ________
  35th Reg. Crest - Green $3.00 ________ ________
    4th Div. Patch $3.00 ________ ________
    25th Div. Patch $3.00 ________ ________
  CIB Bumper Sticker $3.00 ________ ________
  35th Reg. Bumper Sticker $2.50 ________ ________
Shipping & Handling ___________
(Orders $5.00 or less are $1.00 S&H, $6.00 to $15.00 are $3.00 S&H, and over $15.00 are $5.00 S&H)

TOTAL COST ___________

  All orders must include Shipping and Handling and be prepaid. Money Order is
  preferred but checks are also accepted. All orders are money back guarenteed,
  including shipping cost for the return. Mail payment to:

Joe Henderson
26 Neptune Lane
Levittown, PA 19054