White Cane Day T-Shirt Order Form

You can place your order for the White Cane Day t-shirts here.  All you need to do is fill out the form and mail it along with your payment to the addresses listed below.  Please fill out all of the information requested below to make this a smooth and simple process.  For any comments and questions please send an email to: White Cane Day T-Shirts

Contact Information

Please provide the following contact information:

Full Name  
Phone  
E-mail

Please provide the following ordering information:

QUANTITY

 2T (2 Toddler):                                  
 3T  (3 Toddler):                                 

 4T (4 Toddler):                                  

 YS (Youth Small):                            
 YM (Youth Medium):                       
 YL (Youth Large):                            
 S (Small):                                          
 M (Medium):                                     
 L (Large):                                          
 XL (Extra Large):                              
 XXL (Extra Extra Large):                   
 XXXL (Extra Extra Extra Large):       

Please indicate the total number of  t-shirts ordered:              

 

For all mail in orders ONLY money orders will be accepted do not send cash.  Please make them out to: Scott Meyer.

Please send order forms and payment to:
Criss Cole Rehabilitation Center
Attention: O&M Department
Mail Code: 6804
4800 N. Lamar Blvd.
Austin, TX 78756

Online orders must be made by 5:00 PM central time Thursday, August 28, 2008.  Orders will continue to be taken in person August 29, 2008 thru 5:00 PM central  time September 4, 2008.

Deadline for all t-shirts orders and payment is 5:00 PM Thursday, September 4, 2008.  Any orders or payments made after this date will not be processed and money will be returned.  No Exceptions.

SHIPPING  INFORMATION
Shipping Address
Apartment Number
City
State/Province
Zip/Postal Code
Country

  By checking this box I am verifying that I intend to order these shirts. I understand that if my payment is not received by 5:00PM central time Thursday September  4, 2008 my order will not be processed. Once you have verified your order select PRINT or press Ctrl P on your keyboard. Be sure to include your order form and any payment in a stamped addressed envelope to the address above. Jaws users press your Plus key on the num pad to activate your virtual cursor and then activate the link below which will take you to the billing and payment info.

Payment and Mailing Information