Print the form below and write in your selections.
Please mail payment for purchases from this organization to:
UTSSHP, 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 |
|---|---|---|
| Chill Pill Navy T | $16 | Select Size: S M L XL |
| Texas Pharmacy Long Sleeves | $19 | Select Size: S M L XL |
Please enter the number of items you want to purchase of each option. If none, leave blank.
Chill Pill Small Size Navy T | ________ |
Chill Pill Medium Size Navy T | ________ |
Chill Pill Large Size Navy T | ________ |
Chill Pill Extra Large Size Navy T | ________ |
Texas Pharmacy Short Sleeves Medium Size White T | ________ |
Texas Pharmacy Long Sleeves Small Size Navy T | ________ |
Texas Pharmacy Long Sleeves Medium Size Navy T | ________ |
Texas Pharmacy Long Sleeves Large Size Navy T | ________ |
Texas Pharmacy Long Sleeves Extra Large Size Navy T | ________ |
Chill Pill Size Navy T ($16 each) | ________ |
Texas Pharmacy Short Sleeves White T ($XX each) | ________ |
Texas Pharmacy Long Sleeves Navy T ($19 each) | ________ |
Total amount due | ________ |
Please submit checks payable to UTSSHP; and, provide the address where the items are to be shipped:
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