Dixie Drifter T-Shirt Order Form

Complete this order form.

NAME ____________________________________________

ADDRESS__________________________________________

CITY___________________ STATE______ ZIP___________

PHONE (___)_________ EMAIL________________________

Large, X-Large, 2X-Large $20.00   (includes shipping)

(Orders placed will take 3 to 4 weeks for delivery)  GRAND TOTAL $__________

Make your Money Order, Cashier's Check or Personal check (must clear) payable to:

Dixie Drifter
PO Box 0015
Dyersburg, TN  38025-0015 

YOUR BUSINESS IS APPRECIATED   THANK YOU

Any questions? Webmaster@dixiedrifter.com

_Copyright © _{1999- www.dixiedrifter.com}
All Rights Reserved
Use Allowed By Permission Only
Revised: March 01, 2007