Juneteenth T-Shirt Order Form
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Contact E-mail
*
example@example.com
My Products
*
prev
next
( X )
#1
$
20.00
T-Shirt
XS
S
M
L
XL
XXL
XXXL
#2
$
20.00
T-Shirt
S
XS
M
L
XL
XXL
XXXL
#3
$
20.00
T-Shirt
Quantity
XS
1
2
3
4
5
6
7
8
9
10
S
1
2
3
4
5
6
7
8
9
10
M
1
2
3
4
5
6
7
8
9
10
L
1
2
3
4
5
6
7
8
9
10
XL
1
2
3
4
5
6
7
8
9
10
XXL
1
2
3
4
5
6
7
8
9
10
XXXL
1
2
3
4
5
6
7
8
9
10
#4
$
20.00
T-Shirt
Quantity
XS
1
2
3
4
5
6
7
8
9
10
S
1
2
3
4
5
6
7
8
9
10
M
1
2
3
4
5
6
7
8
9
10
L
1
2
3
4
5
6
7
8
9
10
XL
1
2
3
4
5
6
7
8
9
10
XXL
1
2
3
4
5
6
7
8
9
10
XXXL
1
2
3
4
5
6
7
8
9
10
#5
$
20.00
T-Shirt
Quantity
XS
1
2
3
4
5
6
7
8
9
10
S
1
2
3
4
5
6
7
8
9
10
M
1
2
3
4
5
6
7
8
9
10
L
1
2
3
4
5
6
7
8
9
10
XL
1
2
3
4
5
6
7
8
9
10
XXL
1
2
3
4
5
6
7
8
9
10
XXXL
1
2
3
4
5
6
7
8
9
10
#6
$
20.00
T-Shirt
Quantity
XS
1
2
3
4
5
6
7
8
9
10
S
1
2
3
4
5
6
7
8
9
10
M
1
2
3
4
5
6
7
8
9
10
L
1
2
3
4
5
6
7
8
9
10
XL
1
2
3
4
5
6
7
8
9
10
XXL
1
2
3
4
5
6
7
8
9
10
XXXL
1
2
3
4
5
6
7
8
9
10
#7
$
20.00
T-Shirt
Quantity
XS
1
2
3
4
5
6
7
8
9
10
S
1
2
3
4
5
6
7
8
9
10
M
1
2
3
4
5
6
7
8
9
10
L
1
2
3
4
5
6
7
8
9
10
XL
1
2
3
4
5
6
7
8
9
10
XXL
1
2
3
4
5
6
7
8
9
10
XXXL
1
2
3
4
5
6
7
8
9
10
#8
$
20.00
T-Shirt
Quantity
XS
1
2
3
4
5
6
7
8
9
10
S
1
2
3
4
5
6
7
8
9
10
M
1
2
3
4
5
6
7
8
9
10
L
1
2
3
4
5
6
7
8
9
10
XL
1
2
3
4
5
6
7
8
9
10
XXL
1
2
3
4
5
6
7
8
9
10
XXXL
1
2
3
4
5
6
7
8
9
10
Delivery
If you would like me to drop off your shirt, you will have to add delivery
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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