Purchase Challenge Coins |
Please print and mail to the address at the bottom of the page. | |
Quantity_____Cost (Member Dues Current) $5.00 ea | Total_$_______ (# Coins*cost ea Member) |
Quantity_____Cost (Non-Member) $6.00ea | Total_$_______ (#Coins *cost ea Non-Member) |
Shipping and Handling 1-4 $2.50, 5-10 $4.50, 10-15 $6.00 | Total_$_______ |
(max 15 coins) | |
Total Coins Purchase + Shipping and Handling | Total_$_______ |
Ship to Address |
Name ___________________________________________
Address_____________________________
Address_____________________________
City______________State______
Zip Code___________
Your Email Address ___________________________________________
Mailing Information |
Make Check or Money Order payable to:
John Holladay
email Doc Holiday @
johnholladay@outlook.com
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