| Excelerator T-shirts, $10.00 each Colors: Black or White Sizes: Medium, Large and X-Large |
| Size_____________Color_____________Quantity________Total___________________ _____________ _____________ ________ ___________________ _____________ _____________ ________ ___________________ _____________ _____________ ________ ___________________ Subtotal___________________ Shipping___________________ Total___________________ |
| Shipping: 2.95 for 1 to 3 shirts 3.95 for 4 or more |
| Name_____________________________________________________ Address___________________________________________________ City/County________________________________________________ State________________________Zip___________________________ E-mail____________________________________________________ |
| Send check or money order to: Jeff Bess 4246 Armstrong Drive Mechanicsville, VA 23111 |
| (Personal checks please allow two weeks to clear) |