Please Print & Fill Out Form and Return with Check / Money Order to the Following Address:

D.S.I. Motorsports Apparel Sales
Attn: Jack Sullivan
83 South Broadview
Greenbrier, Arkansas 72058

Please Make Checks/Money Orders Payable to: Jack Sullivan

Please Allow 2-3 Weeks Delivery Time (Depending on Availability & Race Schedule)
NAME:(Please Print)______________________________________________________________
ADDRESS:______________________________________________________________________
CITY:________________________________________STATE_________ZIP:_______________
DAYTIME PHONE:________________________EVENING PHONE______________________
EMAIL ADDRESS:_______________________________________________________________

ITEM #1: 2007 JACK SULLIVAN LOGO SHIRT

DESCRIPTION PRICE QUANTITY TOTAL $
2007 White Jack Sullivan Logo T-Shirts - Made by ASI Racewear      
Youth Medium
 $15.00 each __________ __________
Youth Large
 $15.00 each __________ __________
Size Small
 $20.00 each __________ __________
Size Medium
 $20.00 each __________ __________
Size Large
 $20.00 each __________ __________
Size XL
 $20.00 each __________ __________
Size 2XL
 $22.00 each __________ __________
Size 3XL
 $22.00 each __________ __________

ITEM #2: 2007 JACK SULLIVAN CAR SHIRT

DESCRIPTION PRICE QUANTITY TOTAL $
2007 White Jack Sullivan Car T-Shirts - Made by New Vision Graphics      
Youth Medium
 $15.00 each __________ __________
Youth Large
 $15.00 each __________ __________
Size Small
 $20.00 each __________ __________
Size Medium
 $20.00 each __________ __________
Size Large
 $20.00 each __________ __________
Size XL
 $20.00 each __________ __________
Size 2XL
 $22.00 each __________ __________
Size 3XL
 $22.00 each __________ __________

ITEM #3: 2007 JACK SULLIVAN WOMEN'S TANK TOPS

DESCRIPTION PRICE QUANTITY TOTAL $
2007 White Jack Sullivan Women's Tank Tops      
Size Small
 $15.00 each __________ __________
Size Medium
 $15.00 each __________ __________
Size Large
 $15.00 each __________ __________
Size XL
 $15.00 each __________ __________

ITEM #4: ASSORTED JACK SULLIVAN DECALS

DESCRIPTION PRICE QUANTITY TOTAL $
Large #18 Window Decal
 $8.00 each __________ __________
Small #18 Window Decal
 $6.00 each __________ __________
D.S.I. Motorsports Window Decal
 $6.00 each __________ __________

SHIPPING & HANDLING

Please Add $7.00 S&H to your Amount Totals
$7.00

GRAND TOTAL

Please Add all Total Amounts + Shipping & Handling __________
JACK SULLIVAN IS NOT RESPONSIBLE FOR LOST ORDERS OR MERCHANDISE. PLEASE SEND ONLY CHECKS OR MONEY ORDERS WITH YOUR PRINTED ORDER FORM. THANK YOU FOR YOUR SUPPORT OF JACK SULLIVAN!!!