Wisconsin EMS Association Merchandise Order Form

 ITEM SIZE PRICE SIZE QTY  TOTAL AMT

 Sweat Shirts

Ragland Hooded Sweat  Med, Large, X-Large, $30.00
Ragland Hooded Sweat  XX-Large $30.00      
Montclair Jersey Sweat Med, Large, X-Large $26.00      
Montclair Jersey Sweat XX-Large $28.00      
Violet V Patch Sweat Shirt Med, Large, X-Large $18.00      
Violet V Patch Sweat Shirt XX-Large $20.00      
Violet V Patch Sweat Shirt XXX-Large $22.00      

Wind Shirts

Tan Wind Shirt  Med, Large, X-Large $28.00      

Sweat Pants

Navy Sweat Pants Med, Large X-Large $16.00      

Ladies Hats and Scarfs

Pink Ladies Hat  Single Size $10.00      
Pink Ladies Scarf  Single Size $10.00

Travel Mug

Black Travel Mug with Lid 20 Ounce $4.00      

Wisconsin EMS Association Patch

Wisconsin EMS Association Patch Includes Shipping $3.00      

Can Coolers

Navy Blue Can Cooler  12 Ounce $2.00      

Wisconsin EMS Poster

Wisconsin EMS Poster Comes flat in mail tube with shipping included $5.00      

2006 Pharmacology Guide

2006 Pharmacology Guide - Over 2,000 Medications Included Includes Shipping $4.95      

Shipping Shipping Shipping Shipping Shipping Shipping Shipping Shipping

Total of Merchandise Items $
Add Wisconsin State and County Sales Tax of 5.5% $
Add Shipping charges of $4.75 for totals up to $29.99, $7.00 totals $30.00 to $49.99, $8.50 for totals $50.00 to 99.99, $10.00 for totals $100.00 to $199.99, and $15.00 for totals of $200.00 and over. $

 Total Amount Enclosed

$

Ship To: ________________________________________________________

Address:  _______________________________________________________

City ______________________________  State _______  Zip ______________

Print this form and send it along with your check or money order to:
The Wisconsin EMS Association, 21332 7 Mile Rd., Franksville, WI 53126-9769
Please allow 2 to 4 weeks for delivery