Blackwater Osprey Cap/Hat/Shirt Order Form
Ms./Mrs./Mr.______________________________________________
Address__________________________________________
City ______________________________________ State _______ Zip _______
Daytime Phone ________________________________________
Email Address _________________________________________
(Note: Please include your email address if you would like to be added to our mailing list.
We will not share your email address with any other party.)
(Please note: Due to changing postage rates, we highly recommend charging your purchases)
Quantity Price Total Osprey Caps (one size) Denim cap (self strap) _______ $18.00 $_______ Olive cap (leather strap) _______ $18.00 $_______ Olive cap w/black bill (leather strap) _______ $18.00 $_______ Osprey Bucket Hats (one size) Denim bucket hat _______ $19.50 $_______ Olive bucket hat _______ $19.50 $_______ Osprey Shirts Small _______ $25.95 $_______ Medium _______ $25.95 $_______ Large _______ $25.95 $_______ X-Large _______ $25.95 $_______ XX-Large _______ $28.95 $_______ Merchandise Total $_______ Less 10% Members Only Discount $_______ Subtotal $_______ Orders shipped to MD addresses add 6% Sales Tax $_______ Shipping:
1 shirt = $5.00
1-2 caps/hats = $5.00$_______ (Any order greater than the above will be
shipped at actual cost with credit card info)Total Amount Due $_______
Payment Type (Circle One)
Check/Money Order Visa Mastercard
Credit Card Number ________________________________
Exp. Date _______ (mm/yy)
CVV or CSV Number* __________
Signature ____________________________________________
(*CVV or CSV - VISA and MasterCard require the three-digit Card Verification Value -- sometimes call Card Security Value -- in addition to the card number. This number is typically found written on the right side of the signature line on the back of the card.)
Make checks and money orders payable to Friends of Blackwater
Mail order to Friends of Blackwater, Inc.
P.O. Box 1231, Cambridge, Maryland 21613
Or fax completed order form to 410-221-7738
Or call 410-901-6125 and leave a message to place an order. All calls will be returned.
For additional information, contact Wolf Hehn at Whehn@aol.com
Thank you for your order!