1. No category

Club shirt order Form
Shirt Costs: Long/short sleeve: $60.00 with name printed on front: $65.00
Shirt Size (from
above list)
Shirt type (long
or short sleeve)
Name to be printed on shirt (leave
blank if you no not want a name)
No. of:
Cost:
TOTAL:
Cheque/Cash
or
Credit card details
Name printed on card________________________________________________________________
Type of card (please tick)
VISA
MASTERCARD
Amount $ ________________
Card No.
Expiry Date:
CCV:
Signature:__________________________________________________________________________
Card Holder’s contact phone number:____________________________________________________