Brockville Squadron
Burgee Order Form
Please place my order for:
Brockville Power and Sail Squadron
50th Anniversary Gold Burgee
____ [insert number] @ $30.00 each - Total: $________
and mail my order to:
| Name: | _________________________________________________ |
| Address: | _________________________________________________ |
| _________________________________________________ | |
| _________________________________________________ | |
| Phone (optional): | _________________________________________________ |
| Email (optional): | _________________________________________________ |
Please print, then complete and mail this order form with your cheque payable to:
The Brockville Power and Sail Squadron
Inquire for current address.