ADIRONDACK FORTY-SIXER ORDER FORM (Revised 11-07)

ALL ORDERS should be sent to: 46er Treasurer, P.O. Box 180, Cadyville, NY 12918

WILL BE SHIPPED BY PHIL:

How Many? Item Price Amount +Shipping

[ ] 3” 46er felt patch (for shirt or pack)……………..… $ 2.00 $_______ $ .50

[ ] 3” vinyl sticker (adhesive on back) …………………… $ 1.00 $_______ $ .50

[ ] 3” vinyl sticker (adhesive on front) …………………… $ 1.00 $_______ $ .50

[ ] 1.75” button, safety pin on back ………………………… $ 1.50 $_______ $ 1.50

[ ] Lapel pin (5/8” emblem with safety catch ……… $ 2.50 $_______ $ 1.50

[ ] Tie Tack (same as lapel pin with clutch clasp) $ 2.50 $_______ $ 1.50

[ ] 1” vinyl stickers, self-adhesive, coil of 65 …… $ 7.00 $_______ $ 1.50

[ ] Jim Goodwin’s Memoirs “And gladly Guide” 127 p. $ 20.00 $_______ $ 2.50

[ ] T-shirt Order Form (see Web Site)

FOR RECORDED WINTER ONLY

[ ] Winter 46er “Rocker” felt patch ………………………. $ 2.00 $_______ $ .50

[ ] Winter 46er vinyl decal (adhesive on back) ……. $ 1.00 $_______ $ .50

[ ] Winter 46er vinyl decal (adhesive on front) ….. $ 1.00 $_______ $ .50

WILL BE SHIPPED BY JEAN:

[ ] 46er Quart Nalgene water bottle w/ logo, mtns. $ 12.00 $_______ $ 2.25

[ ] 46er Cotton Bandana w/ mountains and logo ……. $ 4.00 $_______ $ 1.00

[ ] 46er Belt Buckle …………………………………………………….. $ 10.00 $_______ $ 2.00

[ ] Grace Hudowalski CD – “14 Mountain Tales” ……. $ 12.00 $_______ $ 2.00

[ ] 46er Cap (green cotton summer, fits all) …………. $ 12.00 $_______ $ 2.00

[ ] 46er Cap (khaki cotton summer, fits all) …………. $ 12.00 $_______ $ 2.00

[ ] “46 Squares” color Poster, 16” x 21” …………………. $ 10.00 $_______ $ 2.75

[ ] “Canister Poster” color photos, 18” x 24” ………. $ 10.00 $_______ $ 2.75

46er Note cards w/ envelopes (pen and ink sketches by Trudy Healy), Package of 12

[ ] 1 pkg. of Trudy Notes (12) …………………………………… $ 3.00 $_______ $ 2.75

[ ] 3 pkgs. Of Trudy Notes (36 total) ……………………. $ 8.00 $_______ $ 4.75

ADD TOTAL FOR THE ITEMS PURCHASED: $______

ADD SHIPPING CHARGE: $______

NEW YORK STATE RESIDENTS ONLY ADD SALES TAX: $______

IF PAYING TAX, NAME YOUR NYS COUNTY: _________________

ANNUAL 46ER DUES: $ 8.00

TAX EXEMPT OPTIONAL GIFT SUPPORTING THE 46ERS MANY SERVICES: $______

TOTAL ENCLOSED: $________

MAKE CHECKS PAYABLE TO: “ADIRONDACK 46ERS”

FILL OUT LABEL BELOW ONLY IF MAKING AN ORDER OR ADDRESS CHANGE. PLEASE PRINT OR ATTACH LABELS. IF ORDERING ITEMS FROM BOTH PHIL AND JEAN, A SECOND LABEL WOULD HELP! THANKS FOR YOUR ASSISTANCE!

MAILING LABEL SECOND MAILING LABEL, if necessary:

NAME: _________________________ NAME: _________________________

STREET/BOX: _________________________ STREET/BOX: _________________________

CITY/STATE/ZIP: _____________________ CITY/STATE/ZIP: _____________________