WHITEWATER MS BAND JACKET ORDER FORM

bring to the bandroom by Dec. 4!!

Name_______________________________________________________________________

Jacket #1:  Charles River 9905:  Nylon/ Flannel Pullover-1/4 zipper, hood, pouch front pockets, drawstring waist, elastic cuffs.

Jacket #2: Charles River 9952:  Nylon Flannel Full Zip, inside storm flap, covered side pockets, elastic cuffs, stand-up collar.

WMS Band logo embroidered on Left Chest, Names on Right Chest

Circle One..................................Jacket #1   or   #2

Jacket with embroidery.................................................$32.00                    ___________

• with 1 name                                                           $36.00                    __________                           
• with two names                                                      $37.00                    __________
• with 1 name and instrument                                  $38.00                   _________
• with 2 names and instrument                                $39.00                   __________
• with instrument only                                                $36.00                   __________

With Jacket Back Design ADD                         $12.00                    ___________

ADD FOR XXL                                                                $4.00                      ____________

ADD FOR XXXL                                                              $6.00                      __________

                                                                                Total Due:                    __________

MAKE CHECK PAYABLE TO:PATRICIA'S SPIRITWEAR INC.,  and attach to your order form.

ADULT SIZES ONLY  (Circle One)      S    M     L     XL      XXL       XXXL

Please Print Clearly

Name(s) On Jacket____________________________________________________

Instrument or Title On Jacket___________________________________________