Democratic Party Mail Order Form

Thank you on behalf of the Democratic Party of you state for your donation through this purchase of Blue Voter American Flag Pins and Tie Tacks.  YOUR DONATION WILL BE SENT TO THE STATE LISTED IN YOUR RETURN ADDRESS.
Please print this page, fill in the ordering information and mail it with your Bank Check, Money Order or Personal Check to:
                                                          I Voted Blue
                                                           PO Box 1327
                                                           Hyannis, MA 02601

DESCRIPTION	QUANTITY	UNIT PRICE	TOTAL
Blue Voter American Flag Pins		$5.00
Blue Voter American Flag Tie Tacks		$5.00
		SUB TOTAL
		ADD SHIPPING
		TOTAL

TOTAL NUMBER OF ITEMS ORDERED		SHIPPING
One or two (1 or 2) Flag Pins and/or Tie Tacks		$2.00
Three to ten (3 to 10) Flag Pins and/or Tie Tacks		$3.00
Eleven to fifty (11 to 50) Flag Pins and/or Tie Tacks		$5.00

 

	SHIPPING INFORMATION (Print Please)
Name
Street Address
Mailing Address
City	State Zip