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First and Last Name:
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Address
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Name on Credit Card
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Type of Credit Card (VISA, Mastercard etc Expiration date and CVC#
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Shirt size ($4.50 shipping charge)
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XS ($20)
S($20)
M ($20)
L($20)
Option 5
2XL ($30.00)
3XL ($30.00)
Option 1
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Shipping address (cost $4.50)
ADK POLO SHIRT - SCHOLARSHIP FUNDRAISER
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