Lonerider Merchandise Order Form

To order, print out this form, fill in the quantity of each item you want and send the form with payment (remember to include shipping and handling costs in your total) to:

Lonerider
P.O. Box XXXX
Germantown, MD 00000
Attn: Merchandise


Note: Personal checks take time to clear, so orders sent with money orders may be received faster than those that include a check.

QTY DESCRIPTION COST
_____ The Walk CD 10.00
_____ Black T-Shirt 100% cotton, Sizes M-L-XL 15.00
_____ Black T-Shirt 100% cotton, Size XXL 17.00
_____ White T-Shirt 100% cotton, Sizes M-L-XL 15.00
_____ White T-Shirt 100% cotton, Size XXL 17.00
_____ Photo Magnet 3.00
_____ Photo Computer Mousepad 8.00
_____ Bumper Sticker - 7 1/2 by 3 3/4 inches. Show the world you're a Lonerider fan! 3.00
_____ Baseball Cap adjustable 12.00
_____ 8X10 Black-and-White Photo Lonerider on railroad tracks, with printed signatures 4.00
 
TOTAL:
 


Shipping and Handling:

Shipping and Handling:

Up to $5.00...........................$1.00
$5.01 to $9.99.......................$3.00
$10.00 to $29.99....................$4.00
$30.00 to $49.99....................$5.00
$50.00 to $69.99....................$6.00
Over $70.00...........................$7.00


For orders outside the USA and Canada, double the normal shipping charges.

Maryland Residents, please add 5% tax.

Send To:
(Please Print)

Name:_____________________________________________

Street Address:______________________________________

City:___________________________________ State:______

ZIP Code:________________


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