Updated 11/11/2009

USS BELKNAP Association SHIP STORE Order Form
Click here to print this page. or Hit the "Print function" on your browser to print this order form.

Item
 #

Available Items

 Price
Each		 Qty
Ordered		 Total $$
this item
C-1 USS BELKNAP (DLG/CG-26)
Challenge Coin
 Size: 1 1/2 x 3/32 inch		 $  8.00 shipping included
1

Merchandise Total =

 $
2

 Shipping Cost (included in price)= 

$           none
3

Total amount remitted =

 $

Please print your "Shipping address"  below.  (Please print clearly, this will be your shipping Label
Your
Name		  
Shipping
Address		  
City /
State / Zip 		 

In the event we need to contact you about this order, please include the below information
which will never be knowingly divulged to anyone other than
the Belknap Association officers required to complete your order.
Email
Address		  
Phone
 Number		  

*
*
*
*
*
*
*
*
*
USS Belknap Ship Store Order Form; Page 2
Instructions and Shipping charge Information

Instructions
  1. Click here to print this page.
    or     Hit the "Print function" on your browser to print this order form.
  2. Please indicate the sizes (if applicable) and the quantity of each item.
  3. Total the cost for each line item.   
  4. In the "Total amount of this order" box, please enter the below information
    Line 1: Total amount of dollars from page 1
    Line 2:  Shipping is included.
  5. Make check out for the amount of Line 3.

Make check or money order for total amount payable to:
USS BELKNAP ASSOCIATION

Remember to put the order form in the envelope with your Check / Money order!

*** Please note that Items ordered will ship within 3 to 4 weeks ***

Mail Order Form Pages, Check / Money order to:

USS BELKNAP Ship's Store
Attn: Chuck Taylor
7207 La Granada
Houston, TX 77083