Free Copy of T-shirt form Excel version.xls - Indiana


File Size: 102.1 kB
Pages: 1
Date: July 21, 2005
File Format: PDF
State: Indiana
Category: Government
Author: mkidwell
Word Count: 348 Words, 2,248 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.state.in.us/icpr/webfile/formsdiv/50253.pdf

Download Copy of T-shirt form Excel version.xls ( 102.1 kB)


Preview Copy of T-shirt form Excel version.xls
Division of Historic Preservation and Archaeology

ORDER FOR ARCHAEOLOGY MONTH T-SHIRTS
State Form 50253 (R3/6-05)

402 W. Washington St., W274, Indianapolis, IN 46204-2739 317-232-1646; 317-232-0693; [email protected]

Form Approved by State Board of Accounts, 2005

Please PRINT legibly.

Name

Telephone Number

(
Address (Number and Street/Rural Route, NO P.O. Box)

)

City, State, Zip Code

QUANTITIES LIMITED. NOT AVAILABLE FOR RE-SALE.
Quantity Size Small Medium Large X-Large XX-Large Unit Price $5.00 $5.00 $5.00 $5.00 $5.00 $ $ $ $ $ Sub-Total

Shipping & Handling (CANNOT SHIP TO PO BOX) 1-3 Shirts 4-6 Shirts 7-10 Shirts 11-15 Shirts 16 -25 Shirts $4.00 $5.00 $6.00 $7.00 $8.00

Merchandise Total $ + Shipping & Handling $ = TOTAL AMOUNT DUE $

Orders exceeding 25 shirts will be subject to the shipping and handling charges as stated above. Example: An order for 55 shirts $8.00 +$8.00 + $5.00 = $21.00

ENCLOSE CHECK OR MONEY ORDER PAYABLE TO: DEPARTMENT OF NATURAL RESOURCES PLEASE DO NOT SEND CASH. SORRY NO COD'S. ALL RETURNED CHECKS ARE SUBJECT TO A $20 RETURN CHECK FEE.

These t-shirts were financed in part with federal funds from the U.S. Department of the Interior, National Park Service, as administered by the Indiana Department of Natural Resources, Division of Historic Preservation and Archaeology. However, the contents and opinions of this product do not necessarily reflect the views or policies of the Department of the Interior, nor does the mention of trade names or commercial products constitute endorsement or recommendation by the U.S. Department of the Interior. Under Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, the U.S. Department of the Interior prohibits discrimination on the basis of race, color, national origin, or disability in its federally assisted programs. If you believe that you have been discriminated against in any program activity, or facility as described above, or if you desire further information, please write to: Office of Equal Opportunity, National Park Service, 1849 C Street, NW, Washington, D.C. 20240.

FOR OFFICE USE ONLY
Date Processed $ Amount Received Check #___________________ Money Order #_____________ Cash Staff Initials