HTML Writers Guild T-Shirt Order Form This is an order form for the official HWG T-Shirts (Guild logo style). These shirts are available while supplies last; reorders are likely. Print this form out and complete it, then mail or fax it to the address at the bottom. Name: ________________________________________________________________ Email: ________________________________________________________________ Shipping Address: _______________________________________________________________________ _______________________________________________________________________ City: ____________________________ State/Prov: _____________________ Postal Code: _____________________ Country: ________________________ Phone Number: ________________________________________________________ Please mark the quantity of each size/color you would like. Guild T-Shirt Med. White ____ Guild T-Shirt Large White ____ Guild T-Shirt XL Black _____ Guild T-Shirt XL White ____ Guild T-Shirt XXL Black _____ Guild T-Shirt XXL White ____ Guild T-Shirt XXXL White ____ Cost per T-Shirt: (inc. shipping) $24.00 U.S/Canada $28.00 other Total amount due (number of shirts x $24/28): ____________ Note that payment must be by one of the following: * Check or money order in *U.S. Dollars* drawn on a *U.S. Bank* * Credit card, charged in *U.S. Dollars* Credit Card Orders: [ ] Visa [ ] Mastercard [ ] American Express [ ] Discover (check one) Card number: _________________________________________________________ Expiration Date: ______/______ Signature: ___________________________________________________________ Mail to: Fax to: HTML Writers Guild, Inc. (941) 833-0142 Attn: Guildwear 126 East Olympia Avenue Suite 406 Punta Gorda, FL 33950