Print the form below and write in your selections.
Please mail payment for purchases from this organization to:
KE, 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 |
|---|---|
| College Koozie (Burnt Orange) | $9 |
| Mug with Longhorn & Pharmacy Seal | $12 |
| College of Pharmacy Fleece Blanket (Available only in Cream w/ Orange lettering) | $28 |
| College of Pharmacy Baseball Cap (Available only in Tan w/ Orange lettering) | $18 |
| College of Pharmacy Towel | $10 |
Please enter the number of items you want to purchase of each option. If none, leave blank.
College Koozie | ________ |
Coffee Mug | ________ |
Fleece Blanket | ________ |
Baseball Cap | ________ |
Towel | ________ |
| Total for koozie(s) - $9 each | _____ |
| Total for mug(s) - $12 each | ________ |
| Total for blanket(s) - $28 each | ________ |
| Total for cap(s) - $18 each | ________ |
| Total for towel(s) - $10 each | ________ |
| Total amount due | ________ |
Please submit checks payable to KE; and, provide the address where the items are to be shipped:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________