PSATS Merchandise Order Form

Name ________________________________________________________________
Township _________________________________
County _____________________________
Address ______________________________________________________________
City ________________________________________
State _____ Zip ____________________
Daytime Phone # (___)____________________________

Year	Description	Cost Each	Tax Each	S & H* Each	Total Each	Quantity	Total Due
2001	Kenworth Snow Plow - White	$49.00	$2.94	$4.00	$55.94
2001	Kenworth Snow Plow - Blue	$49.00	$2.94	$4.00	$55.94
2000	Ford Backhoe	$57.00	$3.42	$4.00	$64.42
1999	Kenworth Cab/Cat Grader	$49.00	$2.94	$4.00	$55.94
1999	Freightliner Cab/Cat Grader	$49.00	$2.94	$4.00	$55.94
1996	Ford Aeromax – 75th Anniversary	$47.50	$2.85	$4.00	$54.35
1996	Kenworth – 75th Anniversary	$47.50	$2.85	$4.00	$54.35
1994	Wood Block on Flatbed	$45.00	$2.70	$4.00	$51.70
	PSATS Hat - Forest Green	$7.52	$.48	$2.00	$10.00
	PSATS Hat - Khaki	$7.52	$.48	$2.00	$10.00
	PSATS Hat - Stone	$7.52	$.48	$2.00	$10.00
	PSATS Hat - Natural	$7.52	$.48	$2.00	$10.00
						Total Due	$

*Shipping & Handling charge per item

Print, fill out and send this form along with your payment to:
Pennsylvania State Association of Township Supervisors
4855 Woodland Drive, Enola PA 17025