Paypal Order Form (self-totaling)

Customer E-Mail

Important: Enter a valid e-mail address. Receipts will be sent to this address.

E-Mail:*

Products for Sale

Item

Size

Qty

Total

Girly Fit T-Shirt Black

Unisex T-Shirt - Gray

Unisex T-Shirt - Black

JTB Car Magnet

JTB Travel Mug

Shipping & Handling

Grand Total:

Billing Information

First Name:*

Middle Initial:

Last Name:*

Address Line 1:*

Address Line 2:

Apt. or Suite No.

City:*

State:*

Zip Code:*

Phone:

Shipping Information

Different than billing info

Yes No

First Name:*

Middle Initial:

Last Name:*

Address Line 1:*

Address Line 2:

City:*

State:*

Zip Code:*

Order Information

Order Number:

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