MAIL ORDER FORM
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MAIL ORDER FORMPrint, fill out the information and send to:

Frank Hazen
2268 Polo Park Dr.
Dayton, OH  45439


Please make Money Orders out to
" Frank Hazen"
SORRY, NO CHECKS....CHECKS DELAY ORDERS 7-10 DAYS TO CLEAR BANK


NAME_______________________________________EMAIL_________________________________________

ADDRESS________________________________________________PHONE (optional)_____________________

CITY________________________________________STATE_________ZIP_____________________________


I
TEM 1.....circle t-shirt or jacket color & size or other

T-SHIRT   (white)...(black) ......DENIM JACKET.....LEATHER JACKET.......OTHER_____________________
SIZE.......Sm   Med   Lg   XL   XXL   XXXL             OPTIONAL SIZE________________________________         

ITEM NAME - # _____________________________________________________________________________

ADDITIONAL INSTRUCTIONS:
___________________________________________________________________________________________

___________________________________________________________________________________________

ITEM 2.....circle t-shirt or jacket  color & size or other

T-SHIRT    (white)...(black)......DENIM JACKET.....LEATHER JACKET.....OTHER______________________
SIZE.......Sm   Med   Lg   XL   XXL   XXXL             OPTIONAL SIZE________________________________        

ITEM NAME -#______________________________________________________________________________

ADDITIONAL INSTRUCTIONS:

__________________________________________________________________________________________

SHIPPING: *** PLEASE ADD***
 
T-SHIRTS_____________US- $5______INTERNATIONAL- $10              * Shipped in 1-3 business days
DENIM JACKETS_______US- $10_____INTERNATIONAL- $15              * Leather - aprox. 7 days
LEATHER JACKETS____US- $15_____INTERNATIONAL- $25


MONEY ORDER AMOUNT  $________  DID YOU ADD SHIPPING?   Thanks....

SIGNATURE____________________________________________