Upper Leacock Fire Company Store Order Form

Reflective Address Sign (Upper Leacock Township Resident)

Numbers Requested on Sign (up to 5) ____ ____ ____ ____ ____

Orientation (Circle one):   Horizontal      Vertical

Sign $15               Delivery - Free             Total cost = $15                 Post available for $5 fee

 

Reflective Address Sign (non-Upper Leacock Township Resident)

Numbers Requested on Sign (up to 5) ____ ____ ____ ____ ____

Orientation (Circle one):   Horizontal     Vertical

Color choice (Circle one):   Green     Blue

Sign $15                    Shipping and Handling $5                      Total cost = $20

 

ULFC Patch

Patch with shipping and handling $5

Additional patches $3 each          Number requested: ______

 

ULFC Sauerkraut Hat

Year(s) Requested (32,33,34, etc): ______________________________

Sauerkraut Hat $8 (each)    Shipping and Handling $5    Total cost = $13

Three (3) hats $20     Shipping and Handling $7     Total cost = $27

 

Please complete the following:                 Mail To:  

Name: _______________________________         Upper Leacock Fire Company

Address: ____________________________           Attn: Store

City, ST, ZIP: ______________________           PO Box 335

Phone Number: __________________                Leola, PA 17540

Total Enclosed : $ ______________                                            Checks payable to:  Upper Leacock Fire Company