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* 1. First and last name?

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* 2. Email?

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* 3. Check all merchandise you would like to purchase and how many of each.

  1 2 3 4 5
T Shirts ($15 each)
Mugs ($11 each)
Stickers ($2 each)
Koozies ($4 each)

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* 4. If you'd like to purchase a shirt, what size would you like?

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* 5. If you'd like to purchase a mug, what color would you like?

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* 6. If you're purchasing multiple shirts or mugs, which sizes/colors would you like?

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* 7. How would you like to pay? 

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* 8. Questions/comments/concerns?

T