| New York State Association of Fire Chaplains,
Inc. SUPPLY ORDER FORM 2018-03 |
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| Please
ship the following NYSAFC, Inc., supplies to: |
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| Name:
_____________________________________________________ |
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| ADDRESS:
_________________________________________________ |
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| CITY/ST/ZIP:
________________________________________________ |
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| Item Description |
PRICE |
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QTY |
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TOTAL |
| Training Materials: |
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| DVD Training Series (3 part) |
$25.00 |
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x |
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| Fire Chaplain Embroidered
Hats: |
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| White Ball Cap (w/logo)
"Chaplain" |
$20.00 |
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x |
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| White Ball Cap (plain)
"Chaplain" |
$15.00 |
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x |
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| Blue Ball Cap (w/logo) "Chaplain" |
$20.00 |
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x |
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| Blue Ball Cap (plain) "Chaplain" |
$15.00 |
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x |
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| Blue Knit Winter Hat |
$10.00 |
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x |
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| Black Skull Cap |
$12.00 |
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x |
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| Red NYSAFC Polo Golf
Shirt: |
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SIZE |
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| With Pocket - S - Xl (specify size) |
$20.00 |
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x |
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| With Pocket - 2X and Larger (specify
Size) |
$25.00 |
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x |
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| No Pocket - S - XL (specify size) |
$20.00 |
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x |
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| No Pocket - 2X and Larger (specify size) |
$25.00 |
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x |
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| Men's Light Blue NYS Assoc
Dress Shirt |
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SIZE |
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| LSleeve S - XL (specify size) |
$30.00 |
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x |
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| LSleeve 2X and Larger
(specify size) |
$34.00 |
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x |
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| Short Sleeve S - XL (specify
size) |
$28.00 |
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x |
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| Short Sleeve 2X and Larger
(specify size) |
$32.00 |
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x |
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| Ladies Light Blue NYS Assoc.
Dress Shirt |
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SIZE |
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| LSleeve S - XL (specify size) |
$28.00 |
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x |
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| LSleeve 2X and Larger
(specify size) |
$32.00 |
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x |
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| Short Sleeve S - XL (specify
size) |
$26.00 |
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x |
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| Short Sleeve 2X and Larger
(specify size) |
$30.00 |
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x |
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| Steel Grey Mock Turtleneck
Shirt w.logo |
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SIZE |
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| LSleeve S - XL (specify size) |
$30.00 |
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x |
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| LSleeve 2X and Larger
(specify size) |
$34.00 |
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x |
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| NYSAFC LOGO ITEMS: Members
Only |
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| NYSAFC Member Badge (New 3" size) |
$75.00 |
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x |
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| NYSAFC Helmet/Window Decal |
$2.00 |
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x |
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| NYSAFC Large Lapel Pin |
$4.00 |
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x |
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| NYSAFC Small Lapel Pin |
$3.00 |
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x |
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| NYSAFC Logo Shoulder Patch |
$4.00 |
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x |
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| Richard Holst Chaplains Bag
(50th Ann.) |
$35.00 |
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x |
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Sub Total |
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| No
Shipping charge if order placed at Conference otherwise |
Shipping
Add 20% to order |
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| Received: ___/___/___ by Supply Officer |
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YOUR ORDER COST |
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| Shipped: ___/___/___ by Supply Officer |
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| If
Paying for your order using PayPal, Please email this form to
NYSAFC@GMAIL.COM |
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Make Check or Money Order Payable (in US Funds) To: NYSAFC, Inc. |
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| Mail
this order form to: NYSAFC, Inc, c/o William Miles, 470 Adam Street,
Tonawanda, NY 14150-1804 |
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