CLUB DESCRIPTION AND PSFCOM BAR MAPSNOTE: Print this form and type or print the information. Each membership is $25.00 and includes a PSFCOM T-shirt. The charge for T-Shirt only is $17. If the T-shirt is mailed to you - add a $5.00 handling charge for each shirt. Mail the form and money to the address below. First Person's Name ___________________________________________________ Address___________________________________________________ City_______________________ State_______ Zip___________ Telephone Number(s)____________________________________________ Email address (optional)______________________________________________ PSFCOM T-shirt Size: (circle one) med large XL 2XL 3XL Second Person's Name ___________________________________________________ Address___________________________________________________ City_______________________ State_______ Zip___________ Telephone Number(s)____________________________________________ Email address (optional)______________________________________________ PSFCOM T-shirt Size: (circle one) med large XL 2XL 3XL 1. PSFCOM LIFETIME MEMBERSHIP(S) ORDERED - ________ X $25.00 = $ ________ Total this order (ADD LINES 1, 2, AND 3): $ ________ Checks payable to: Pittsburgh Steelers Fan Club of Maryland Send this completed order form and check to: Chris Binaut RETURN TO PSFCOM'S WEBSITE.
2. T-SHIRT(S) ONLY ORDER - ________X $17.00= $________
3. T-SHIRTS(S) MAILED TO YOU - ________ X $5.00 (HANDLING CHARGE) = $ ________
3704 Century Ave.
Baltimore, MD. 21227