Use the form below to order an exclusive Ruby Tee or Polo Shirt. No payment required now. PLEASE ORDER BY 22nd SEPTEMBER 2016

Once we have the printed shirts ready, we will contact you to arrange a pick up/delivery point where you will be able to pay.

All proceeds to HeartKids WA

Name

First Name

Last Name

Address

Contact Phone

Email Address

$25 T-Shirts No. and Size (e.g. 1 x Kids 14 + 2 x Adult M)

Kids 6 8 10 12 14 Adult S M L XL XXL

$30 Polo Shirts No. and Size

Adult S M L XL XXL

Total

Ruby Shirts