Please Print & Fill Out Form and Return with a Check or Money Order to the Following Address:
Justin Rattliff Racing
122 Cambridge Way
Campbellsville, KY 42718
Please Write Checks Payable to: Justin Rattliff
| NAME:(Please Print)______________________________________________________________ |
| ADDRESS:______________________________________________________________________ |
| CITY:________________________________________STATE_________ZIP:_______________ |
| DAYTIME PHONE:________________________EVENING PHONE______________________ |
| EMAIL ADDRESS:_______________________________________________________________ |
| DESCRIPTION | PRICE |
QUANTITY | TOTAL |
| 2007 White Short Sleeve Shirt from Arizona Sport Shirts | |||
Size XL |
$20.00 |
__________ | __________ |
| Size 4XL |
$20.00 |
__________ | __________ |
| Size 5XL |
$20.00 |
__________ | __________ |
| DESCRIPTION | PRICE |
QUANTITY | TOTAL |
| #16 Fitted Black Hats | |||
One Size |
$20.00 |
__________ | __________ |
| DESCRIPTION | PRICE |
QUANTITY | TOTAL |
| #16 Mini Doors | |||
One Size |
$15.00 |
__________ | __________ |
| DESCRIPTION | PRICE |
QUANTITY | TOTAL |
| #16 Window Decal | |||
One Size |
$5.00 |
__________ | __________ |
| Please Add $5.00 S&H to your Amount Totals | $5.00 |
| Please Add all Total Amounts + Shipping & Handling | __________ |