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CLAN LOCKHART
STORE ORDER FORM

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Item Nbr. Description Qty Size
indicate choice		 Cost / Item Shipping * Total
#10000 17oz. 54in. Cotton Lockhart Tartan     $25.00/yd $2.00/yd  
#10001 Red Cotton T-Shirt   XL $12.00 $2.50  
#10002 Forest Green Polo Shirt   M, L or XXL $29.00 $3.00  
#10003 Navy Polo Shirt   L, XL or 2XL $29.00 $3.00  
#10014 Burgundy Polo Shirt   XL $29.00 $3.00  
#10004 Small Blue Tote Bag     $19.00 $2.50  
#10005 Forest Green Sweat Shirt   M $30.00 $4.50  
#10006 Navy Sweat Shirt   L, XL or XXL $30.00 $4.50  
#10008 White Thistle T-Shirt   S,M,L,XL,2XL or 3XL $10.00 $2.50  
#10009 Sterling Silver Clan Pin - by Special order only     $75.00 $5,00  
#10010 Large Blue Cotton Tote Bag     $22.00 $3.00  
#10011 Large Red Cotton Tote Bag     $22.00 $3.00  
#10012 Large Green Cotton Tote Bag     $22.00 $3.00  
#10013 Large Black Cotton Tote Bag     $22.00 $3.00  
* NOTE: Shipping charges are cost of orders sent within USA. If sent out of USA, shipping will be more. Contact Clan Lockhart Store Keeper for shipping charges out of USA. Total Amount  

For Clan Use Only

Make Check Payable to:Clan Lockhart, Inc.

Send Check along with Order Form via Postal Mail to:
Thelma Lockhart
3193 Harding Avenue
East Liverpool, OH 43920

Nov 23, 2003