Golden Wolves Gear Apparel Fundraiser
Print out and FAX this order for to 954-968-6808

PLEASE PRINT CLEARLY

Name: _____________________________________ Phone: ______________________________ Date:_____________

Address: _______________________________________________________ Alt Phone: _________________________

Email: _____________________________________________________ Team Name:____________________________
Description
Style #
Color
Size
Price
Qty
Total

           
             
             
             
             
             
             
             
             
             
             
Total $ Amount of Items:
 
3% processing fee for credit card payment (VISA & MC only):
 
SUB-TOTAL:
 
Add for special sizing (call or email edit@platinumapparel.com to request & get pricing):

Sales Tax (6%):
 
This is a not-for-profit fundraiser to benefit the South Florida Golden Wolves.
TOTAL:
 

Cash or checks preferred if paying in person. Please make checks payable to Platinum Apparel, Inc. ------ All Sales Final

To place order via FAX, please make sure this form is fully completed and FAX to: 954-968-6808

(Check one: __VISA __MC) Card # __________________________________________________ Exp: _____________

Name on Card: ____________________________________________ ( __ billing address is same as above)

Billing Address: _______________________________________________ City: ________________________________

State:__________ Zip:________________ Signature: _____________________________________________________

Your order will be placed with the next twice monthly order and you will be notified via email when items are ready to be picked up at Pines Ice Arena. If you prefer to be otherwise notified, please note on this form prior to faxing.