Order Form

Print this page, complete in pen, and mail with check to

Florida Jim, 2520 McCormick Road, Southport Florida, 32409

Make Check Payable to: Floridajim

(Return to Products)

Qty

Item

Each

 Total

  Service Yellow Ribbon Lapel Pin $12.00  
  License Plate $30.00  
  Loved One Lapel Pin $7.00  
       
       

 

 

 

Sub total

 

 

  Florida Residents add 7% Sales Tax    

 

Add $5.00  Shipping and Handling

 

 

       
       
  Total    

Special Instructions - Include any appropriate instructions.

 

 

 

Include appropriate photographs.

Name: _____________________________________________

Address____________________________________________

City, State __________________________________________

Zip____________

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