Texas Good Sam Chapters Accessories Order Form Title Strip - $1.75 @ Qty Description Total ___ President $_____ ___ Vice President $_____ ___ Secretary $_____ ___ Treasurer $_____ ___ Past $_____ ___ Retired $_____ ___ Charter Member $_____ ___ Wagonmaster $_____ ___ Chaplain $_____ ___ Historian $_____ ___ Editor $_____ ___ Assistant $_____ ___ Director $_____ ___ State $_____ ___ R-V Pilot $_____ ___ R-V Co-Polit $_____ Military Patches - $3.00 @ Qty Description Total ___ U.S. Army Veteran $_____ ___ U.S. Navy Veteran $_____ ___ U.S. Air Force Veteran $_____ ___ U.S. Marine Corp Veteran $_____ ___ Civil Service Retired $_____ Misc. Patches - $2.50 @ Qty Description Total ___ Eastern Star Patch $_____ ___ Shriner Patch $_____ ___ Masonic Patch $_____ Good Sam Accessories Qty Description Cost Total ___ Good Sam Vest Guard $5.50 $_____ ___ Good Samantha Vest Guard $5.50 $_____ ___ Good Sam Pin $5.00 $_____ ___ Good Samantha Pin $5.00 $_____ ___ 12" Good Sam Decal $4.25 $_____ ___ Good Sam 2", 3", 5" Decal Sheet $1.50 $_____ ___ Good Samantha 2", 3", 5" Decal Sheet $1.50 $_____ ___ Mini Good Sam Decal (100/Set) $1.10 $_____ ___ Good Sam Number Set $1.50 $_____ ___ 7" Good Sam Patch $5.50 $_____ ___ 3" Good Sam Patch $2.00 $_____ ___ 3" Good Samantha Patch $2.00 $_____ ___ Good Sam Flag (12x18) $9.95 $_____ ___ Good Sam License Plate Frame $7.00 $_____ ___ Good Sam Pledge $0.85 $_____ ___ U.S. Flag Patch (Straight) $2.75 $_____ ___ U.S. Flag Patch (Wavy) $2.75 $_____ ___ Texas Flag Patch $2.75 $_____ ___ U.S. Map Patch (Color In) $4.50 $_____ ___ North America & Hawaii Map Patch (Color In) $6.50 $_____ ___ U.S. Flag (12x18) $8.00 $_____ ___ Texas Flag (12x18) $8.00 $_____ ___ 3 Hole Flag Holder for 3/8" Dowell $5.75 $_____ ___ 3/8" Dowell for Flags $2.25 $_____ ___ 6" Texas Good Sam Chapter Emblem $3.50 $_____ ___ Century Patch $3.75 $_____ ___ Century Star $1.00 $_____ ___ Region IV Patch $3.75 $_____ ___ Caravan Patch $2.25 $_____ ___ Caravan Rocker $1.00 $_____ ___ Year (2000 etc.) $1.00 $_____ ___ Bumper Sticker (Spending Inheritance) $1.75 $_____ ___ Good Sam Doll $7.50 $_____ Sub-Total This Column $_____ Postage & Handling $ 1.00 Total Amount Enclosed $_____ Mail Order Form To: Texas Patches C/O: John & Pat Harris 4401 FR. 2525 Early, Texas 76802 Phone Contact: (915) 643-2765 / 642-8242 Shipping Information: Chapter: __________________________ Name: __________________________ Address: __________________________ City: __________________________ State: ______________ Zip: ______________ Date: __________________________