the P.U.R.E. band Store - Merchandise Order Form
ITEM
DESCRIPTION
PRICE
QUANTITY - SUBTOTAL


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Shirt - Size: Small $ 10.00
Shirt - Size: Medium $ 10.00
Shirt - Size: Large $ 10.00
Shirt - Size: X Large $ 10.00
Shirt - Size: XX Large $ 10.00

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CD - P.U.R.E. Live $ 40.00

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Cap $ 19.00

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Button (1 1/2") $ 2.00

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Magnet (3") $ 2.00
Please enter TOTAL after printing this page : $
Prices Include Tax And Shipping.
Shipping Information
First Name:
Last Name:
Street Address:
City:
State:
Zip:
Phone ( Optional ) :
E-Mail Address:
Special Shipping Instructions:

Please print this page after entering your information & mail it with your check or money order to:
P.U.R.E. Merchandise
624 Third Street
Herndon, VA. 20170
Please Make Your Check or Money Orders Payable To: Jim Sowder

After printing this form, click on SEND. This will email us your order so that we can screen out any problems.

Please allow 1 - 2 weeks for delivery. Thanks!