Print out this form on your printer and mail to:
Please include MONEY ORDER made payable to"Combat Dynamics"
Money orders recieved, shipped same day.
If paying by personal check, allow 7 daysfor check to clear before shipment.
Name__________________________________________________
Address________________________________________________
Gran hotel EnnisCity ________________________ State ______ Zip____________
| QTY | UNIT PRICE | TOTAL | SIZE | |
| TOM BRYAN'S WHITE TIGER KEMPO T-SHIRT (red or black) | ____ | $15.00 | $________ | ____ |
| TOM BRYAN'S WHITE TIGER KEMPO SATIN JACKET (black) | ____ | $79.00 | $________ | ____ |
| EMBROIDERED JACKET (Dragon or Tiger) circle one (specify Tom Bryan's Combat Martial Arts or Combat Dynamics Self Defense Systems) circle one | ____ | $179.00 | $________ | ____ |
| NAME FOR EMBROIDERED JACKET (on front)_______________________ | X | X | $________ | X |
| SIZES: Y/S-Y/L-S-M-L-XL | ____ | $39.95 | $________ | X |
| Add $3.00 shipping and handling per item | ____ | $3.00 | $________ | X |
TOTAL DUE: | $________ |