SideOut Club Merchandise Order Form

Fill out the order form below. Enter the number of each shirt you want in the column for the size you want.
Shirt Number of
each size

Price
per
Item

 Item Total
S M L XL
Grey long sleeve shirt #290         $14  
Green long sleeve shirt (bridge) #261         $16  
Black t-shirt (bridge) #281         $12  
Subtotal:  
Shipping: $3.75
Total:  

Enter your billing information below. We will only contact you by e-mail or phone if there is a problem with your order.
Name:  
Address:  
 
City, State, Zip:  
 
E-mail address:  
Phone number:  
 
Credit card number:
(Master Card or Visa only) 		  CVV/CVC number:
(3-digit number on back of card)		  
Expiration date:
(Month and Year) 		 

If you want the order shipped to an address different from your billing address, enter it below.
Name:  
Address:  
 
City, State, Zip:  

Print this form and mail it to:
Jim Constandt
13603 Grace Dr.
Eagle, MI 48822