Iceshanty Militia Order Form

Select Package

Iceshanty Militia Platinum Package  1 year
@ $ 75.00 + $8.95 S&H  = $ ______   Select Size: L-XXXL _____   Select Hoodie Style:________________

Iceshanty Militia Gold Package   1 year
@ $ 50 + $5.95 S&H  = $ ______  Select Cap Style Style:________________

Iceshanty Militia Silver Package   1 year
@ $ 30 + $3.95 S&H  = $ ______

Iceshanty Militia Forum Extras Only Package  1 year
@ $ 20  = $ ______

Iceshanty Militia Trial Package  1 month
@ $ 15  = $ ______



Taxes


       + $ ______   For addresses in Wisconsin PLEASE ADD 5.5% sales tax on merchandise.





   




 MERCHANDISE

   SUBTOTAL     = $ ______   sum of everything above

Shipping Address and Contact Information

Name: _____________________________________________________________________

Street Address1: __________________________________________________________

Street Address2: __________________________________________________________

City/State/Province: ______________________________________________________

Zip/Postal Code: _________________________________________________

Country: _________________________________________________

Day Time Phone number: ____________________________________________________

Iceshanty Forum Username: ____________________________________________

Iceshanty Forum Email Address: ____________________________________________

Payment

Send orders and inquiries to

Email: militia@iceshanty.com