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ARTICLES FEATURING THE CHI EPSILON EMBLEM (12/20/03)

Mail Order w/Payment to: Chi Epsilon, UTA, Box 19316, Arlington, TX 76019-0316

ORDER FORM

ITEM	PRICE Each	QTY	TOTALS
Key Tag, Soft Plastic	$ 1.50		$
Bumper Sticker (approx. 3" x 12")	$ 1.00
Brass Key Casting, 4 ½" size (rough,)	$ 9.50
Tie Tack post (use with standard key) w/o chain	$ 2.00
Tie Tack post (use with standard key) w/chain	$ 3.85
Blue (cobalt color) Coffee Mug (gold key imprint - microwave safe)	$10.00
Polo Shirt w/ pocket (white) M, L, XL	$35.00
Polo Shirt w/ pocket (purple) M, L, XL	$35.00
White Baseball Cap	$14.00
T-Shirt w/pocket (white) M, L, XL	$18.50
75th Anniversary Seal (sticker) 3 or more, each	$ .60
1997 National Honor Member Roster	$13.00
Parlimentary Procedure Pamphlet	$ 2.00
Wall Clock (XE Face)	$23.00
Purple Stole	$28.00
Purple Collar	$28.00
White Stole	$28.00
White Collar	$28.00
New Items
Edition Hat Embroider	$20.00
Window Decal - Clear	$ 1.75
12" Triangle Scale Combo	$18.50
License Plate Holder	$ 2.55
Duo-Tone Noble Mug - Plum	$13.00
25oz Starburst Sport Mug	$22.50
Twister Mug	$ 6.50
2oz Shot Glass	$ 4.25
Bronze Paper Weight (6oz) Satin or Cut & Polish	$30.00

General #: ____________________________

XE Chapter: __________________

Grad. Yr.: ____________________________

Please Ship to:

Member Name:

____________________________

Address: _________________

____________________________

Day Phone: ________________________

**OFFICIAL JEWELRY**

Certificate of Appreciation (For Chapters Only)	$13.50
Certificate Replacement	$10.00
10K Gold Key	$82.75
Goldgloss Key, gold plated (standard)	$16.50
Sweetheart Key, 10K gold (white spinal/pin)	$59.00
Sweetheart Key, 10K gold (red stone/pin)	$56.50
Sweetheart Key, 10K gold (white spinal/post)	$48.50
Sweetheart Key, 10K gold (red stone/post)	$60.00
Colibri Pen (black) Roller Ball w/miniature key	$47.00
Cross Pen (Gold Plated) w/miniature key	$57.00
Key Chain (Gold Plated) w/key	$27.00
Necklace Charm (Gold filled) w/ “XE” engraved, ¾”F	$32.50
Gold filled Rope Chain, 18” (for charm)	$19.00
Money Clip (Gold Plated) w/miniature key	$23.00
XE Key Paper Weight (3 ½”) w/red stone	$35.00
PRICE LISTED INCLUDES SHIPPING & HANDLING		Subtotal	$
Credit Card Service Fee		4.5%
		Grand Total	$

PAYMENT METHOD: 1 CHECK payable to Chi Epsilon Check #: _________

1American Express 1Discover 1MasterCard 1Visa

Account Number: ____________________________________

Expiration Date: ____________________

Name (as it appears on Credit Card: ____________________________________

Signature: _________________________________________________________________