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RLC PATCH ORDER FORM

 

Mail check or money order in U.S. funds and this completed form to:

Piper's Enterprises
P.O. Box 529
Shawnee Mission, KS  USA
66201-0529
phone- 913-432-7473
 
15" Shield Patch $39
12" Oval Patch $22
4 " Shield Patch $10
Pic
3 " Oval Patch
Now: $5 Pic
American Flag Patches $2 Pic (or 2 for $3.50)
Prices above are in US Dollars.

Patch Size  Border
(Red or Black)
Quantity   X   Price    =     Cost
       
       
       
       
       

Kansas, USA, residents add 7% sales tax.
Add $2 for shipping outside of the U.S.

                                            TOTAL COST ………………… $

Shipping Information / Sold To:

Name: _____________________________________________

Street Address: ______________________________________

City/State/Country: ____________________________________

Zip (or postal code): ________________ Phone: _____________