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Order Form

CDs & CAPS

To order by mail, fill in this form. Print it from your computer and mail, along with check or money order, to:

Mt. Hood Kiwanis Camp
9320 SW Barbur Blvd., Suite 165
Portland, OR 97219

First Name

Last Name

Address

City

State, Zip  

Phone Number



Ship to if different from above:

First Name

Last Name

Address

City

State, Zip  

Phone Number


 

ITEM

COLOR SIZE PRICES
EACH
 UNITS

$SUB TOTAL

WEIGHT
EACH

WEIGHT
SUB-TOTAL

Camp CD

 N/A

 N/A

 $5.00 

     4 oz.  

Cap 1

 Black

 One  Size

 $15.00

   

 6 oz.

 

SUBTOTALS

             

POSTAGE

             

 Postage and Handling:
 1 pound=16 ounces
 Less than 1 lb.=$5.35, 1 lb. to 1 lb. 15 oz.=$5.75, 2 lbs. to 2 lb. 15 oz.=$6.00
 3 lbs to 3 lbs 15 oz.=$6.25, 4 lbs. to 4 lbs 15 oz.=$6.50

 Check enclosed made payable to Mt. Hood Kiwanis Camp

 VISA/MC, AMEX, DISCOVER #____________________Expiration Date__ / __ / __

 Signature___________________________Date________

 Please allow 3 to 4 weeks for delivery