Millarkey Apparel Mail-In Order Form
Print - Fill Out - Mail In

Please send me the following Millar T-Shirts:  

Total: _______________

Please allow 2 weeks for shipping.

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Name: _____________________________________________________________

Company: __________________________________________________________

Shipping Address: _____________________________________

City: ______________________________________________________________

State: _______________________________________ Zip Code: _____________

Mailing Address (if different): ___________________________________________

Phone (Days): ____________________ Phone (Eves): ______________________

e-mail Address: _____________________________________________________

Special Instructions:__________________________________________________

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Select Payment Type:

Check Type: ____Cashiers ____ Money Order ____ Certified _____Personal Check
Check Number: __________________
(personal checks need to clear our bank before order is shipped)
Make checks payable to: Orah Mae Millar

Mail Payment & Order Form To:
Millarkey T-shirts
41 Peninsula Center - Suite 311
Rolling Hills Estates, CA 90274

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