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 Size Color Quantity Cost
  Light Weight Jacket $40.00 XXXL
XXL
XL
L
M
Dark Green ________ ________
  Assn. Golf/Polo shirt $25.00 XXXL
XXL
XL
L
M
White
Blue
OD
Grey
Khaki
________ ________
  T Shirt $20.00 XXXL
XXL
XL
L
M
Bue     Tan
Grey    Gold
Red
Camo
OD
________ ________
  Belt Buckle $20.00     ________ ________
  Assn Coffee Mug $10.00     ________ ________
  35th Regiment Coin $10.00     ________ ________
  Assn Ball Cap $15.00     ________ ________
  Vietn Ribbon Cap $10.00     ________ ________
  Assorted Hats $10.00   4th Viet  25th Viet
25th Korea
CIB Viet
Purple Heart
________ ________
    35th Money Clip $10.00     ________ ________
  35th Key Ring $10.00     ________ ________
    Dog Tags $10.00   Include Info ________ ________
    License Cover $15.00   Include Info ________ ________
    10 in. Assoc Patch $25.00     ________ ________
  Assoc Patch $5.00     ________ ________
    35th Regt Patch $5.00     ________ ________
    4th ID Patch $5.00   White
OD
________ ________
    25th ID Patch $5.00   Red
OD
Brown
________ ________
  CIB/CMB Lapel Pin $5.00   CIB
CMB
________ ________
  CIB (Full Size) $5.00     ________ ________
  35th Regt Crest $3.00   Blue
Green
________ ________
  CIB Bumper Sticker $3.00     ________ ________
  35th Bumper Sticker $3.00     ________ ________
  United We Stand
Bumper Sticker
$3.00     ________ ________
Shipping & Handling ___________
(Orders $5.00 or less are $1.00 S&H, $6.00 to $15.00 are $5.00 S&H, and over $16.00 are $8.00 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