Print the form below and write in your selections.
Please mail payment for purchases from this organization to:
Phi Delta Chi, 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 | Item Options |
|---|---|---|
| Smiley Face T | $15 | Select Size: S M L XL |
| Window Decal | $6.50 | |
| Pharmacy Art | $6 | |
| Mortar and Pestle | $30 |
Please enter the number of items you want to purchase of each option. If none, leave blank.
Small Size Smiley Face T | ________ |
Medium Size Smiley Face T | ________ |
Large Size Smiley Face T | ________ |
Extra Large Size Smiley Face T | ________ |
Window Decal | ________ |
Pharmacy Art | ________ |
Mortar and Pestle | ________ |
| Total number of t-shirts - $15 each | ________ |
| Total number of decals - $6.50 each | ________ |
| Total number of Pharmacy Art prints - $6 each | ________ |
| Total number of Mortar & Pestle Sets - $30 each | ________ |
| Total amount due | ________ |
Please submit checks payable to Phi Delta Chi; and, provide the address where the items are to be shipped:
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