Embroidered Railroad Garments Embroidered Railroad Garments
Jelsma Graphics Order Form
Three ways to order from Jelsma Graphics:
  • Call us at 904-716-0436 (Monday through Friday 8-5 ET)
  • Connect to the Internet and visit www.jelsma.com
  • Print and mail this order form to:
Jelsma Graphics
2238 Winding Creek Lane
Jacksonville, FL 32246-4136
Description (include size and color) Item # RR Logo # RR Logo on Front Name on Front Qty Item Price Total $
1. $ $
2. $ $
3. $ $
4. $ $
5. $ $
Subtotal $
RR Logo on front (add $11 per item) - For Jacket Only $
Name on front (add $10 per item) - For Jacket Only $
7% Sales Tax (Florida originating addresses) $
Shipping & Handling
1-3 prints ($7.50)  -  4+ prints ($8.95)  
1-2 shirts ($8.50)  -  3+ shirts add $1.50 each. (4 shirts = $8.50 + $1.50 + $1.50)  
Jackets ($9.50)  -  2+ add $2.50 each (4 Jackets = $9.50 + $2.50 + $2.50 + $2.50)  
1-2 brass ($17.00)  -  2+ add $3.50 each (4 Brass = $17.00 + $3.50 + $3.50)  

International Customers add:
Canada  + $3.00
Mexico + $8.00
S. America / Puerto Rico + $13.00
Europe + $13.00
Australia / NZ + $13.00
Asia + $13.00
Africa + $15.00		 $
Grand Total $
SHIPPING INFORMATION
Name:
Company:
Address:
City:
State:
Zip / Postal Code:
Country:
E-Mail Address: (Used only in case of questions)
Phone # (Used only in case of questions):
 
PAYMENT INFORMATION
Pay by:
Cashier's Check, Certified Check, or Money Order
Personal Check
VISA      MasterCard      American Express     Discover     Charge on Account
Card #
Expiration Date
Credit Card Billing (if different than shipping address)
Name:
Address:
City:
State:
Zip / Postal Code:
E-Mail Address:
Phone # (Used only in case of questions):
Embroidered Railroad Garments