PRINTABLE MERCHANDISE ORDER FORM

* Print this form.
* Write in order information.
* Send completed form with check
  to the address at the bottom of the page.

Name: ______________________________________________________

Street Address: ____________________________________________

City: ______________________________________________________

State: _____________________________________________________

Zip: _______________________________________________________


COMPACT DISKS - $10.00


____ Moments of Clarity     Quantity ___     Total $________

____ Driven                 Quantity ___     Total $________

____ Alienate               Quantity ___     Total $________

____ NE Plus Ultra          Quantity ___     Total $________  


SHIRTS
Short Sleeve - $10.00
Long  Sleeve - $15.00


____ Short Sleeve Large     Quantity ___     Total $________

____ Short Sleeve XL        Quantity ___     Total $________

____ Short Sleeve XXL       Quantity ___     Total $________ 

____ Long Sleeve Large      Quantity ___     Total $________

____ Long Sleeve XL         Quantity ___     Total $________

____ Long Sleeve XXL        Quantity ___     Total $________


                                         Sub Total $________

                                    Sales Tax (6%) $________

                          Postage ($2.00 per item) $________

                                             Total $________ 


Send completed order form and check or money order payable to
George Carmen to SLACK P.O. Box 193, Franklin Park, NJ 08823
******The Reverends of SLACK thank you for your order******