House DevnoH, Inc. Direct Sales Order Form.
(click the link for
a photo of item)
QTY ITEM COLOR Size BACK
Print* Price EA.
___ KAG T-Shirt ______ _____ __Yes / __No $15.00
___ KAG Pin $
6.00
___ KAG Patch $
5.00
___ KAG Dome Labels $ 1.00
___
TOTAL ENCLOSED = QTY
x Price EA. + S&H per chart below.
Name:
__________________________________________________
Address:
_______________________________________________
City:
________________________ ST: ____ Zip: ___________
Phone:
____________________ (in case of order questions)
Instructions: Print
this form and mail it along with check or
Money Order made
payable to: “House DevnoH, Inc.” to:
Mail to: Fraternal
Order of House DevnoH, Inc
c/o Rick Day, treasurer
123 Luckie Street NW #1204
Atlanta, GA 30303
770-329-1591, if questions.
*while supplies last, we reserve the right to
substitute.