Texas VROC
Apparel/Accessory ORDER FORM


Ordering Instructions:
     1. Print out this order form.
     2. Fill in your full name, address and email address.
     3. Indicate what items to buy by filling in the item and quantity.  
     4. If you order a T-Shirt please include info for the *rockers, size & color.

*NOTE* T Shirt Purchases - Upper rocker info is your name or handle. Lower rocker info is your VROC# or hometown. You must provide this info to process your order.

Please make your checks or money orders payable to "M. Ginsel". Help avoid delays by including all information on the order form. Prices listed on this form include shipping and handling. Please mail your orders to the following address:

M. Ginsel
6100 Laird Dr.
Austin, Tx. 78757

Ship Items To:

Name: _____________________________________________

Address:____________________________________________

City: _______________________________________________

State: ________________ Zip: _________________________

Telephone Number: ___________________________________

Email Address: ___________________________________

Item (Indicate desired quantity and size) Cost Per Sub-total
     
Texas VROC Patch (3" diameter)
     ______ Quantity 		$4.00   
Texas VROC Lapel Pin
     ______ Quantity 		$3.00  
Texas VROC T Shirt 
     ______ Quantity       _____________Color    Logo  Back____  Front____

_______________________Top Rocker  __________________ Lower Rocker

                                          Size______________

$18.00 
Texas VROC T Shirt 
     ______ Quantity       _____________Color    Logo  Back____  Front____

_______________________Top Rocker  ___________________ Lower Rocker

                                          Size______________

$18.00 
Total:
   

Please allow 1 week for delivery. All orders will be sent via USPS.