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LETTER JACKET
ORDER FORM
Please complete and
submit with cash/check
to the Athletic Office
Checks should be made to:
NHS Athletics
NAME:___________________________________________
DATE:___________________
GRADE: __________ SPORT(S)_______________________________________________
Jacket Choice (check one):
Ladies Cut: Black Letter Jacket w/Gold Sleeves & Zippered Hood
Small
Mens Cut:
Small
Medium
Large
Gold Letter Jacket w/Black Sleeves
Medium
Large
XL
XXL(add $10)
Cost:
$ 55.00*
$ 35.00*
$ ________
$ ________
$ ________
*Your cost is greatly reduced due to Miller Backers contribution towards this$award
________
Mens Cut:
Ladies Cut:
Hood example (Ladies only):
Script Embroidery Option on Hood (Ladies Only)
(up to 3 Lines – Maximum 15 Characters
Line 1 _______________________________
$ 12.00
$ ________
Line 2 _______________________________
$ 12.00
$ ________
Line 3 _______________________________
$ 12.00
$ ________
Total
$ ________
PAYMENT DUE WITH ORDER
OFFICE USE ONLY:
SPORT(S):
_______________
POINTS
_________
DATE ORDERED/PYMT REC’D ____________
_______________
_________
DATE PROCESSED
____________
_______________
TOTAL POINTS
_________
DATE of PICK-UP
____________