Westercon 54 T-Shirt Form

T-Shirt prices are as follows:

• Small to XL: $15
• XXL to XXXL: $17
• Shipping: $2.25 for the first, $1.25 for each additional shirt (within the US only -- email jlorentz@spiritone.com if you are outside the US)

Please print out this form, fill it out, and mail it with your payment to:

Westercon 54
P.O. Box 5901
Portland, OR 97228-5901

Name _____________________________________________________________

Address __________________________________________________________

City/State _______________________________________________________

ZIP/Postal Code __________________  Phone ________________________

E-Mail Address ___________________________________________________



    _______ Small shirt(s)  @ $15 = $________

    _______ Medium shirt(s) @ $15 = $________

    _______ Large shirt(s)  @ $15 = $________

    _______ XL shirt(s)     @ $15 = $________

    _______ XXL shirt(s)    @ $17 = $________

    _______ XXXL shirt(s)   @ $17 = $________

    Shipping:

         First shirt      @ $2.25 = $________

         Additional shirts @ 1.25 = $________


    TOTAL . . . . . . . . . . . . . $________