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.