Band Uniform Order Form

Red Jacket $25    
Name added to jacket $3 additional    
Blue Aussie Hat $10    
Blue or White Bib Pants $15    
Band Uniform Pillows
Non-Personalized $32    
Name on bottom band $35    
Year on bottom band $35    
Name & Year under Chest Logo $35    
Both year & date on bottom band $38    
TOTAL  

NAME_______________________________________________________

ADDRESS____________________________________________________

PHONE NUMBER____________________________________________

EMAIL ADDRESS____________________________________________

PERSONALIZATION__________________________________________

ALL ORDERS MUST BE PREPAID. ALLOW 30-40 DAYS FOR COMPLETION.

Make checks payable to: "CHS BAND & ORCHESTRA PARENTS"

(Pick up orders at the school. Arrangements will be made.)

Mail Orders: Mary Davis, 2224 E. 45th St., Davenport, IA 52807

For more information contact Mary Davis at larry.t.davis@surfmk.com or at 563-355-6189.