Merchandise Patch $5 Pin $5 T-Shirt $ 20 Merchandise Order Form Police Square Club T-Shirt SizeSmall $20Medium $20Large $20X Large $20XX Large $20XXX Large $20XXXX Large $20T-Shirt QuantityWould you like to order a 2nd T-Shirt in a different size? Yes Police Square Club T-Shirt SizeSmall $20Medium $20Large $20X Large $20XX Large $20XXX Large $20XXXX Large $20T-Shirt QuantityPolice Square Club Patch Price: $5.00 Quantity: Police Square Club Pin Price: $5.00 Quantity: Shipping Total $0.00 Shipping InformationName* First Last Phone*Email* We will only contact you if we have questions about your order. Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PaymentCredit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name
