Please make checks payable to: NIVFC, and write "Merchandise" on the memo line.
Print, complete, and mail this form to:
North Irwin Fire Company
Corner of 2nd St. & Broadway Ave.
North Irwin, PA 15642
ATTN: T-Shirts-George Neat

Name:

 

 Address:

 

 

Phone:

 

Email:

 

 City:

 

Check #:

 

 Check Amount:

 

Order Must Be Received By April, 23 to receive new shirt

 State:

 

 Zip:

 

  
Size Quantity Description Price Each Price
      $ $

 

     $ $
      $ $
      $ $
      $ $
      $ $
      $ $
      $ $
      $ $
      Total Price: $
        S/H $7.95
        Total Charges:

$

Any questions please contact the webmaster @ webmaster@northirwinfd.org and place Merchandise in subject line.
All proceeds benefit the North Irwin V.F.C. Truck Fund

Thank you for your purchase!