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Pocono Mountain Regional
Police Department

Clothing Order Form

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Clothing Order Form

First Name:

Last Name:

Local Address

City State Zip

Ship to Address (if different from above)

City State Zip

Local Phone Other Phone

E-Mail address: (order confirmation will be sent via email with final cost)

Clothing List: Please indicate quantity, color, and size when ordering shipping will be added to the order. An email message will be sent with the total cost and you will be asked to verify that you still wish to place the order. (Orders will ship within 7 days.)

Sample: T-shirt in blue

T-shirts: Cost $11.00 (sm, med, lg & XL) $12.00 (XXL) / Colors: (blue, gray, white, black, green)

Small (SM) Quantity Color  

Medium (Med)Quantity Color  

Large (Lg) Quantity Color  

X-Large (XL) Quantity Color  

XX-Large (XXL) Quantity Color  

Golf Shirts: Cost $34.00 / Colors: (blue, gray, white, black, green)

Small (SM) Quantity Color  

Medium (Med)Quantity Color  

Large (Lg) Quantity Color  

X-Large (XL) Quantity Color  

XX-Large (XXL) Quantity Color  

Sweat shirts: Cost $30.00 (sm, med, lg & XL) $32.00 (XXL) / Colors: (blue, gray, white, black, green)

Small (SM) Quantity Color  

Medium (Med)Quantity Color  

Large (Lg) Quantity Color  

X-Large (XL) Quantity Color  

XX-Large (XXL) Quantity Color  

Sweatpants: Cost $23.00  / Colors: (blue, gray, white, black, green)

Small (SM) Quantity Color  

Medium (Med)Quantity Color  

Large (Lg) Quantity Color  

X-Large (XL) Quantity Color  

XX-Large (XXL) Quantity Color  

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