PORTSMOUTH MOTORCYCLE CLUB
101 FRONT STREET
PORTSMOUTH, OH  45662



PRINT THIS ORDER FORM AND MAIL IT WITH YOUR PAYMENT
FOR ADDITIONAL ITEMS, USE BACK OF FORM


ITEM SIZE QTY PRICE TOTAL
         
         
         
         
         
         

SUBTOTAL 

 


NAME _________________________________________________________
ADDRESS _________________________________________________________
CITY ________________________ ST _______ ZIP _____________
EMAIL _________________________________________________________
SHIPPING*  
ORDER TOTAL  


* SHIPPING INFORMATION:
 

LAPEL PINS

 - $1.50 ($0.25 for each additional pin)
 

T-SHIRTS

 - $4.00 ($2.00 for each additional shirt)

PLEASE ALLOW TWO (2) WEEKS FOR ORDER PROCESSING.
SHIPPING VIA USPS TO ADDRESSES IN THE UNITED STATES ONLY.

 

PAYMENT INFORMATION:
PLEASE MAKE CHECK OR MONEY ORDER PAYABLE TO:  

PORTSMOUTH MOTORCYCLE CLUB
101 FRONT STREET
 PORTSMOUTH, OH  45662

 

THANK YOU FOR YOUR ORDER!