PLEASE READ INSTRUCTIONS and answer ALL questions carefully. "Order Co-ordinator" must complete the following form completely to qualify for the above offer. While each member of your order group must personally call our toll-free order line to confirm their order information and provide payment arrangements, accurracy of the information given will insure speedy processing of your request. In addition, this information is used to estimate cost for each jacket. Discrepencies will delay processing of your group's order.

Group/Organization Name for this order

Group/Organization's Colors (please Check Only One):