| BRI Merchandise Order Form |
| ITEM | PRICE | X | QTY | = | TOTAL |
| Monroe County Interim Report | $15.00 | X |  |
= | |
| City of Bloomington Interim Report | $12.00 |
X | |
= | |
| Taking the High Ground: A Portrait of Maple Grove Road | $25.00 |
X | |
= | |
| Historic Monroe County Courthouse Photo Poster |
$10.00 |
X | |
= | |
| Knit T-Shirt Circle size:  SM MED
LG XL Circle color: BLACK HUNTER GREEN
MAROON NAVY BLUE
|
$15.00 |
X | |
= | |
| Knit Polo Shirt Circle size: SM MED
LG XL Circle color: BLACK HUNTER GREEN
MAROON NAVY BLUE
|
$20.00 |
X | |
= | |
| Sweat Shirt Circle size: SM MED
LG XL Circle color: BLACK HUNTER GREEN
MAROON NAVY BLUE
|
$20.00 |
X | |
= | |
| Denim Shirt Circle size: SM MED
LG XL
| $25.00 |
X | |
= | |
| House Plaque Please specify exact text: |
$35.00 | X | |
= | |
| Total amount due Please make checks payable to BRI | = | |
|
Name:
. |
|
Address:
. |
City:
State:
Zip:
. |
|
Telephone:
Email:
. |
| . Interested in becoming a member of BRI? ____ Check here to receive a brochure about BRI and
member benefits.
. |
|
Please print out this page, |
Bloomington Restorations, Inc. 2920 E. Tenth St. Bloomington, IN 47408 |