RUTHERFORD COUNTY FLAG ORDER FORM

- COST -

SINGLE SIDE BANNER --- $130 each(by 9/28/04)     $200(after 9/28/04)

or

DOUBLE SIDED FLAG --- $200 each(by 9/28/04)     $287(after 9/28/04)

This is the official Rutherford County Flag as adopted by the Rutherford County Commision in August 2004.
To purchase one or more, print this form and fax or mail to Screen Art not later than 9/28/04 to recieve the discounted initial offering rate. After 9/28/04 the price will be at regular cost. for additional information or to obtain pricing for large quantities, contact Mike Bickford at 615-890-7511.
- CONTACT INFORMATION-
ORGANIZATION_____________________    P.O.#_____________________

NAME_____________________________    PHONE#___________________

ADDRESS__________________________   TAX EXEMPT?_______________

CITY, STATE,ZIP______________________________________ 

TAX I.D.#__________________
- ORDER INFORMATION-
QUANTITY
ITEM
COST EACH
EXT. COST
 
SINGLE SIDE BANNER
 
 
 
DOUBLE SIDED FLAG w/ HEADING & GROMMETS
 
 
 
TAX CALC. - BANNER$____each   FLAG$____each   TAX
 
 
 
TOTAL ENCLOSED
 
 
- PAYMENT INFORMATION-
CHECK # _________   AMOUNT_____________    ENCLOSED?________

CREDIT CARD #__________________   EXPIRATION DATE ___________

  MASTERCARD or VISA (circle one)    NAME ON CARD________________

SUBMIT TO: SCREEN ART - 502 SUNSET AVENUE, MURFREESBORO, TN 37129
PHONE: 615-890-7511   FAX: 615-895-1553    EMAIL: KINGTSHIRT@COMCAST.NET
[ S C R E E N   A R T ]
PHONE # 615.890.7511   FAX# 615.895.1553
502 Sunset Avenue, Murfreesboro, TN 37129
screenart@comcast.net