|
|
Qty |
|
Total |
|
T-Shirts
|
_______
|
Adult
Small @ $20.00
|
_______
|
|
|
_______
|
Adult Medium @ $20.00
|
_______
|
|
|
_______
|
Adult
Large @ $20.00
|
_______
|
|
|
_______
|
Adult
XL
@ $20.00
|
_______
|
|
|
_______
|
Adult XXL
@ $22.00
|
_______
|
|
Color Preference: Yellow or Gray
|
|
|
|
Prints
|
_______
|
Ed Tiley Limited Edition
Print
(Unframed)
$50.00 |
_______
|
|
|
_______
|
Sam Lyons Limited
Edition Print (Unframed)
$110.00
|
_______
|
|
Stickers
|
_______
|
Non-Member Stickers $5.00
|
_______
|
|
Pins
|
_______
|
$5.00 ea.
|
_______
|
|
Patches
|
_______
|
$5.00 ea.
|
_______
|
|
Memberships
|
|
Individual
@ 25.00
|
_______
|
|
|
|
Family @ $50.00
|
_______
|
|
|
|
Keeper @ $100.00
|
_______
|
|
|
|
Business
@125.00
|
_______
|
|
|
|
Lifetime Member @
$500.00 |
_______
|
|
|
|
Lifetime Patron
$500 or more |
_______
|
|
Shipping
|
|
Please include $3.00 shipping
per T-Shirt or Print. For 1 pin, or up to 4
patches $1.65 |
_______
|
|
|
|
|
|
|
Total
|
|
|
_______
|
|
|
|
|
|
|
Please print and fill out the
form & make check
payable to
"St. George Lighthouse
Association" and send to:
|
|
|
St. George Lighthouse
Association
|
|
|
201 Bradford Street
|
|
|
St. George Island, FL
32328
|