Street address:

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How many shirts would you like? 0 1 2 3 4

Shirt # 1 : Small medium large X-large XX-large XXX-large

Shirt # 2: Small medium large X-large XX-large XXX-large

Shirt # 3: Small medium large X-large XX-large XXX-large

Shirt # 4: Small medium large X-large XX-large XXX-large

If ordering baseball cap:

Please make check or money order out for $19.99 for each item ordered and add $4.99 for shipping and handling.

Only one shipping/handling charge is necessary per order form.

Please allow time for personal checks to clear. Make checks or money orders out to
"NYPD Pipes & Drums".

Print and send this form with your check/money order to:

NYPD Pipes and Drums
166-25 Powells Cove Blvd apt. # 21J
Whitestone, NY 11357

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