2AMPD Order Form

Join the 2AMPD, take a stand with your Neighborhood Watch Pistol Team Window Display and help spread the word as an Honorary Reserve Officer with your own Business Cards (10 ea) ...

Membership(s)	X $15.00 = TOTAL	$
Add Window Sign	X $5.00 = TOTAL	$
Add Ten (10) Cards	X $5.00 = TOTAL	$
GRAND TOTAL		$

High quality picture of the 2ampd window sticker

What your 2ampd business card wiill look like

We Accept VISA or MC: Card# Expire Date:

To pay with check, cash or money order, complete this form and print for snailmail to:

Leroy Pyle

1313 N. Ritchie Ct. #2108

Chicago, IL 60610

Please provide the following information:

*Name		type name (as desired on business cards)
Name#2		(if more than one membership ordered)
Name#3
*Street Address
Address (cont.)
*City
*State/Province
*Zip/Postal Code
Country
Home Phone
*E-mail
URL
*Mandantory Fields