Please complete this form and mail to:
ISG Plate Fire Department
P.O. Box 11241
Lancaster, PA 17605
Name: ______________________________________________
Address: ____________________________________________
City, State, Zip: _______________________________________
Email: ______________________________________________
Item
Qty Total
Department Uniform Patch ($5.00)
____ _____
"Foam Wagon 75" Fitted Hat ($15.00)
Small / Medium ____
_____
Large / X-Large ____ _____
Total Amount of Order
_____________