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2021 RAJAH SHRINE SHIRT
ORDER FORM
NOBLE’S SHIRTS
Sport-Tek Ombre Heather Short Sleeve Polo Shirt
Moisture-Wicking, snag resistant, and 100 % Polyester
Med $42 ___ Large $42 ___ XL $42 ___
2X $44 ___ 3X $46 ___ 4X $48 ___
Additional $ 3.00 - If you would like your name embroidered on the Left Sleeve
Please Embroider Name : ____________
LADY’S SHIRTS
Sport-Tek Heather Short Sleeve Polo Shirt
Moisture-Wicking, snag resistant, and 100 % Polyester
Small $20 ___ Med $20 ___ Large $20 ___ XL $20 ___
2X $22 ___ 3X $24 ___ 4X $26 ___
RUNS SMALL IN SIZE
________ I will pick up my shirt (s) at Rajah Shrine Office
________ Please mail my shirt (s) for an EXTRA $4.00 per shirt.
NAME: ______________________________________
PHONE: __________________
ADDRESS: ________________________________________________________________
CITY: ____________________________________ STATE: ______ ZIP: ____________
Mail completed form and check payable to : RAJAH SHRINE
PO Box 40, Blandon, PA 19510 Phone: 610-916-9000
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