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Please print and submit this form
with your check payable to:
Westport River Watershed Alliance (WRWA)
P.O. Box 3427,
Westport, MA 02790
Name: _______________________________________________________________
Address: _____________________________________________________________
City, State, Zip: ________________________________________________________
Tel # __________________________ E-Mail: _____________________________
Quantity |
Item |
Circle Size |
Cost each |
S/H each |
| |
WRWA Hat |
one size |
$ 20 |
$ 2 |
|
WRWA Jacket Womens |
S, M, L, XL |
$ 60 |
$ 4 |
|
WRWA Jacket Mens |
S, M, L, XL |
$ 60 |
$ 4 |
| |
WRWA boat bag |
|
$ 15 |
$ 5 |
| |
2008 Calendar |
|
$ 15 |
$ 2 |
| |
Fish Hawk Book |
|
$ 10 |
$ 2 |
| |
Osprey Note Cards |
12 per pack |
$ 10 |
$ 2 |
TOTAL |
$ |
Charge your merchandise on Mastercard, Visa, AMEX, DISC
| Type of Card (circle): Mastercard, Visa, AMEX, DISC |
| Amount $ |
Exp. Date: |
| Card Number: |
| Name on Card: |
last 3 digits (code on back) |
| Billing address if different than above: |
The Westport River Watershed Alliance is a membership-supported,501(c)(3) nonprofit organization.
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