Name: _______________________________________________

Phone Number: ______________________

Circle what you want:

Jacket  $60.00         Pants $40.00         Shirt $45.00

 Sizes – Boys - 12 /14 / 16   
             Mens - Small / Medium / Large / XX Large / XXX Large

 Payment Options

1- Place this form in an envelope with cash or cheque and give it to Mike McGlinn (Seniors) or Ian Bycroft (Juniors) by 01 October 2008

or

2- Fax this form with Credit Card Details to Pete Best at 08  6210 1484

or

Post it to Datastor Computer Services, PO Box 963, South Perth, WA  6951

Credit Card Details

Name on Card _______________________________________________

Number _______________________________________________

Expiry ______________________________

Signature ______________________________

Your will see a debit for Datastor Computer Services