ORDER FORM
For 10-10-50 Wristbands
** Please print or type clearly
From & Ship to Information:
Name:___________________________________________________________________
Phone #: ________________________________________________________________
Address:__________________________________________________________________
Address 2:________________________________________________________________
City:_____________________________________________________________________
State:_____________________________________ Zip Code:_____________________
Email:___________________________________________________________________
Order Information:
Item: 10-10-50 Wristbands How Many: ____ Price Each: $1.00 Total For Items: $_________
Shipping & Handling: $___2.50___
Total for Order: $_________
Check or Money Order Only, No Cash Accepted:
Send completed order with check or money order to:
African Community Centers 3079 Campbellton Rd. S.W. Suite 114 Atlanta, GA 30310
Phone: 404-344-5454
Make check or money order out to: African Community Centers