Print this ORDER FORM, fill out, mail in. Make checks or money order payable to U.S.P.C.A. and mailed to:

Daniel A. Page
National Supply Officer
60 Greenleaf Terrace
Stafford, VA 22556
Item No. Name of Item Price Total Qty. Total
1 USPCA Trailer Hitch Covers Temporarily Out of Stock
Cirlce Item: [USPCA Logo]  [Puppy Paw]
   
2 St. Michael Coin [1 -5: $6.00] [6 -10: $5.75] [11 - 19: $5.50]    
3 USPCA Challenge Coin [1 -5: $10.00] [6 -10: $9.50] [11 - 19: $9.00] [20+: $8.50]    
4 Refillable Thermal Bruiser Mug - 22oz. [1 -5: $5.00] [6 -10: $4.75] [11 - 19: $4.50] [20+: $4.25]    
5 Refillable Thermal Cruiser Mug - 16oz. [1 -5: $4.00] [6 -10: $3.75] [11 - 19: $3.50] [20+: $3.25]    
6 U.S.P.C.A. Ceramic Mug [1 -5: $5.00] [6 -10: $4.75] [11 - 19: $4.50] [20+: $4.25]    
7 U.S.P.C.A. BADGE [1 -5: $6.00] [6 -10: $5.75] [11 - 19: $5.50] [20+: $5.25]    
8 Certification Bars [1 -5: $3.00] [6 -10: $2.75] [11 - 19: $2.50] [20+: $2.25]
List bars desired:
   
9 Certified PD I Medal (Pewter) [1 -5: $4.00] [6 -10: $3.75] [11 - 19: $3.50] [20+: $3.25]    
10 K-9 Insignia Pins [1 -5: $6.00] [6 -10: $5.75] [11 - 19: $5.50] [20+: $5.25]
Circle One: Gold  Silver  Black
   
11 U.S.P.C.A. Jewelry (Logo) [1 -5: $4.00] [6 -10: $3.75] [11 - 19: $3.50] [20+: $3.25]
Circle One: Tie Tack  Lapel Pin  Stick Pin
   
12 Collar Badge Holder (Leather) [1 -5: $5.00] [6 -10: $4.75] [11 - 19: $4.50] [20+: $4.25]    
13 Embroidered U.S.P.C.A. Patch [1 -5: $4.00] [6 -10: $3.75] [11 - 19: $3.50] [20+: $3.25]    
14 License Plate Frame (Metal) [1 -5: $5.00] [6 -10: $4.75] [11 - 19: $4.50] [20+: $4.25]    
15 License Plate Frame (Plastic) [1 -5: $3.00] [6 -10: $2.75] [11 - 19: $2.50] [20+: $2.25]    
17 U.S.P.C.A. Embroidered Shirt [1 -5: $25.00] [6 -10: $24.50] [11 - 19: $24.00] [20+: $23.50]
Circle Color: red  navy  royal blue  white & grey
Circle Size: M  L   XL  XXL
   
18 U.S.P.C.A. Jewelry (Round – Gold or Silver) [1 -5: $4.00] [6 -10: $3.75] [11 - 19: $3.50] [20+: $3.25]
Circle One: Gold  Silver
   
19 Dog Paw Window Sticker [1 or More: $2.00 ea.]
Circle One: K9 Unit  Plain (no K9 unit)
   
20 K-9 Cops T-Shirt [1 -5: $8.00] [6 -10: $7.75] [11 - 19: $7.50] [20+: $7.25]
Circle One:Dad  Mom  Uncle  Grandpa
Circle Size: Extra Small   Youth Small  Youth Medium  Youth Large  Youth XLarge Adult Sizes:   Small  Medium  Large
   
21 USPCA Navy Blue T-shirt [1 -5: $8.00] [6 -10: $7.75] [11 - 19: $7.50] [20+: $7.25]
Circle Size: Extra Small   Youth Small  Youth Medium  Youth Large  Youth XLarge Adult Sizes:   Small  Medium  Large
   
22 Navy Blue Nylon Windbreaker [1 -5: $25.00] [6 -10: $24.50] [11 - 19: $24.00] [20+: $23.50]
Circle Size: Large  X-Large  XX-Large  XXX-Large
   
23 USPCA Golf Towels [1 -5: $10.00] [6 -10: $9.75] [11 - 19: $9.50] [20+: $9.25]    
24 We Remember Magnetic Ribbon [$2.00]    
         
         
         
         
    Total Merchandise    
    Shipping   $5.00
         
         
    Total    

Please indicate shirt sizes on the back of order form.

Mailing Instructions:

Name_____________________________________________________________

Address___________________________________________________________

City, State, Zip ____________________________________________________

Phone No._________________________________________________________

No Credit Cards or C.O.D. orders please. Most orders shipped regular first class mail. Checks or Money Orders should be made payable to: U.S.P.C.A. and mailed to Daniel A. Page, National Supply Officer, 60 GreenLeaf Terrace, Stafford, Va. 22554. Ph: 540-752-1337. Note: On all items ordered in quantity discount there may be additional shipping billed to purchaser. Our prices don't allow us to cover the extra freight.