BW T-SHIRT 

- Print this form!

____Additional shirts @ $5.00 = $ ______________

PDSSN Buddy Walk Tee Shirts ( ONLINE PAYMENT AREA! ) are guaranteed to those pre-registered by the deadline. Please complete this tee shirt order form and send it with your registration by October 1, 2011. Only a limited number of shirts will be available for sale the day of the walk.

Pick up shirts before the walk__________ ... or at the walk _______?

Make check payable to:
PDSSN should be written in the memo section
Please mail this completed form & your check to:
Laura Laxton, 824 Chester Road, Winston Salem, NC  27104