Please Print Clearly
Club Name, State _________________________________________________________________

Ship to Attention _________________________________________________________________

Address _______________________________________________________________________

City, State, Zip ___________________________________________________________________

Telephone # _____________________________________________________________________

E-mail __________________________________________________________________________

 

1999 NCC Pin	__________	X $5.00 ea	Total	$ ________
2002 10th Anniversary Pin	__________	X $5.00 ea	Total	$ ________
2003 "Is it Raining?"	__________	X $5.00 ea	Total	$ ________
2004 NCC Pin	__________	X $5.00 ea	Total	$ ________
2005 "Ed the NCC Snowman" Pin	__________	X $5.00 ea	Total	$ ________
2006 NCC Pin	__________	X $5.00 ea	Total	$ ________
2007 15 Anniversary Pin	__________	X $5.00 ea	Total	$ ________
2007 "Snowflake" Pin	__________	X $5.00 ea	Total	$ ________
Shipping $1.00 (1-5 pins); $2.00 (6-20); $3.00 (over 20)			Shipping	$ ________
Subtotal Pin Amount				$ ________
"Ed" Figurine	__________	X $15.00 ea	Total	$ ________
Jack's Umbrella Shop	__________	X $66.00 ea	Total	$ ________
"Snowflake", the NCC Snowgirl	__________	X $12.50 ea	Total	$ ________
Total Amount Enclosed				$ ________
* One free snowman with each 15 snowmen ordered

 

Please include this form with your order and send to:	National Council of 56 Clubs
Make checks out to the NCC (US dollars only)	930 Litchfield Turnpike
	New Hartford, CT 06057

 

If you have any questions, contact Randy Miller, NCC President at 860-482-7935 or e-mail him at presidentncc@ncc56.com