Burgee & Decal Order Form

 

Name:______________________________________

Address:_____________________________________

City:________________    ST: ___        Zip:_________

Phone:____________________    Email:_____________

 

Item

Cost

Number Wanted

Total Cost

Burgee

  $30.00

 

 

Decal

   $5.00

 

 

 

 

Total Cost:

 

 

Delivery Information

___Please bring my order to the marina and I'll pick it up there.

___Please mail my order to the address above.

 

Print this form and mail, with a check payable to "Regent Point Yacht Club" to:

Regent Point Yacht Club

C/O Steve Charbonneau

10955 Brandy Wood Ter

Chesterfield Va 23832