Continuum of Care · Continuum Unity T-Shirt Order Form

Customer Information

Name

*

First Name

Last Name

Email

*

Verify Email

*

Phone

*

Program

*

Select the Continuum program you are with, if applicable.

Please Note: All designs will be printed on blue t-shirts.

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DESIGN 1

Enter quantity in the box below each size you need for Design 1

Small

Medium

Large

XL

2XL

3XL

DESIGN 2

Enter quantity in the box below each size you need for Design 2

Small

Medium

Large

XL

2XL

3XL

DESIGN 3

Enter quantity in the box below each size you need for Design 3

Small

Medium

Large

XL

2XL

3XL

Subtotal/Payment

Total: Shirts

*

Please enter the total amount of shirts ordered

Amount Due

*

Shirts are $10 each. Please enter the total amount due.

Payment method

*

Please check off how you will pay for your shirt. Details on how to pay will be sent in an email.

Debit/credit card

Cash

Check