MCITTA GEAR LOCKER ORDER FORM
Name: _____________________________________________________
Mailing Address: ____________________________________________
City:__________________________State:______Zip+4_____________
Phone:_______________________E-Mail:________________________
Please indicate the number of items desired and total price.
ITEM
DESCRIPTION
COST
NO.
TOTAL
INDIVIDUAL ITEMS
Challenge Coin
Combat IPW (Provide Proof)
$6.00 ea.
One Only
$_________
Challenge Coin
Regular Bronze die cast
$6.00 ea
No.____
$_________
Lapel Pin
Colorized Enameled
$5.00 ea
No.____
$_________
Blazer Patch
Cloth Embroidered
$4.00 ea
No.____
$_________
ECONOMY SETS
Commitment
Coin Pin Patch
$14.00 set
No.____
$_________
Loyalty
Coin Pin
$10.00 set
No.____
$_________
Unity
Coin Patch
$9.00 set
No.____
$_________
Spirit
Pin Patch
$8.00 set
No.____
$_________
SUBTOTAL
_______
$_________
Shipping and Handling (Priority US Mail)
$
4.00
GRAND TOTAL
$_________
Mail orders to:
MCITTA PX
c/o Harry J. Todd
Box 917 Raughley Hill Rd
Harrington, DL 19952-3167
Make checks payable to: MCITTA
Please allow 2 to 4 weeks for delivery of your order.
MONEY BACK GUARANTEE IF NOT COMPLETELY SATISFIED.
The MCITTA is supported only by the generous donations of its members. Please consider making a tax-
deductible donation in any amount. Why not include a small amount with your order?
DONATION
$_________
Website: www.mcitta.org