Broward Women’s Republican Club, Federated T- Shirt Order Form

Name __________________________________________________________________

Address ________________________________________________________________

City, State ______________________________________________________________

Phone __________________________________________________________________

Email __________________________________________________________________

Shirts: $10.00, Postage/Shirt: $2.00

Sizes Large & X-Large

# of T-Shirts in order ______________

Become a member of Broward Women’s Republican Club, Federated

*Female resident of Florida not a member of another Federated Club - $25.00

*Every other U.S. Resident $15.00

Total $ Enclosed (Shirts + Postage + Membership) _________________

Mail total in a check or money order to:

Antonia Hyland

427 Deer Creek Run

Deerfield Beach, FL 33442

Thank you for your support.