Please return this form with

payment attached.

Student Name_______________________

Teacher______________________ grade_____

Cost: $15.00 each   

Please choose size and quantity:

Youth- ___S   ___M   ___L

Adult- ___S   ___M   ___L   ___XL   ___XXL

Quantity_____ x $15 each = Total $_________

Please make checks payable to Plymouth PTA.