PLEASE FILL COMPLETELY

NAME

FIRST: __________________________________________

LAST: __________________________________________

SCV Mechanized Cavalry

Membership NUMBER: # _____________________

ADDRESS

STREET: __________________________________________

City: __________________________________________

STATE: __________________________________________

ZIP CODE: __________________________________________

 

      ITEM NUMBER         DESCRIPTION           QUANTITY          COST       TOTAL

1._____________________________________________________________

2._____________________________________________________________

3._____________________________________________________________

4._____________________________________________________________

5._____________________________________________________________

BE SURE TO LIST SIZE SHIRT NEEDED-- VERY IMPORTANT

                                                                                     TOTAL____________

MAIL CHECK OR MONEY ORDER TO :

CALVIN HART

4884 VICTORIA CHASE CT.

JACKSONVILLE, FLORIDA

32257

(904) 730-0343