CoolStreets Order Form

Name:  __________________________________________________________  Mailing Address:  __________________________________________________________  City:  __________________________________________________________  State:  __________________________________________________________  Zip:  __________________________________________________________  Home Phone:  __________________________________________________________  Work Phone:  __________________________________________________________     Check one: Check Money Order  Quantity  Title  Price  Subtotal  _______  CoolStreets T-Shirt  $19.95 ea.  $___________  _______  circle size: S - M - L - XL - XXL - XXXL      _______  CoolStreets Baseball Cap  $12.95 ea.  $___________  _______  CoolStreets Mouse Mat  $9.95 ea.  $___________          _______  SHIPPING WITHIN THE CONTINENTAL U.S.  $7.50 ea.  $___________              Total:  $___________ Send your check or money order to: CoolStreets 32009 Wallington Court Westlake Village, CA 91361 USA

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