Print the form below and write in your selections.
Please mail payment for purchases from this organization to:
JOPS, College of Pharmacy
The University of Texas at Austin
1 University Station, A1900
Austin, TX 78712-0120
USA
(Note: All prices include shipping and handling charges. T-shirts are in adult sizes.)
Questions about the items may be sent to The College of Pharmacy. Please include the name of the organization selling the item in your message.
| Item Description | Item Price |
|---|---|
| Mesh Shorts (Black) | $15 |
| T-shirt (red) | $12 |
| Polo Shirt (Black, Blue, Green, Beige) | $20 |
Please enter the number of items you want to purchase of each option. If none, leave blank.
Small Mesh Shorts | ________ |
Med Mesh Shorts | ________ |
Large Mesh Shorts | ________ |
XL Mesh Shorts | ________ |
Small T-Shirts | ________ |
Med T-Shirts | ________ |
Large T-Shirts | ________ |
XL T-Shirts | ________ |
Small, blue, Polo Shirts | ________ |
Med, blue, Polo Shirts | ________ |
Large, blue, Polo Shirts | ________ |
XL, blue, Polo Shirts | ________ |
Small, black, Polo Shirts | ________ |
Med, black, Polo Shirts | ________ |
Large, black, Polo Shirts | ________ |
XL, black, Polo Shirts | ________ |
Small, green, Polo Shirts | ________ |
Med, green, Polo Shirts | ________ |
Large, green, Polo Shirts | ________ |
XL, green, Polo Shirts | ________ |
Small, beige, Polo Shirts | ________ |
Med, beige, Polo Shirts | ________ |
Large, beige, Polo Shirts | ________ |
XL, beige, Polo Shirts | ________ |
| Total for Mesh Short(s) - $15 each | ________ |
| Total for T-Shirt(s) - $12 each | ________ |
| Total for Polo Shirt(s) - $20 each | ________ |
| Total amount due | ________ |
Please submit checks payable to JOPS; and, provide the address where the items are to be shipped:
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