Questions or comments? Send to:
sales@146760.net

2003, 2004
Order Form

Print out this page and complete the information below.  Please type or print clearly

Name: ___________________________________

Call Sign: _________________________________

Address: __________________________________

City, State, Zip: _____________________________

Telephone: ________________________________

E-Mail: __________________________________

Description & Size

Qty

Price

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

Call Sign

 

Subtotal

 

Shipping (2.00 ea.)

 

Total

 

Return this form along with check or money order made out to:  Lincoln Amateur Radio Club (or LARC) to:

Lisa Morones
5725 St. Paul Ave
Lincoln, NE  68507

Delivery options available in Lancaster County upon request. Write to sales@146760.net to inquire.