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