T-Shirt Order Form

All net profits will go directly to the relief efforts in Japan – Japan Red Cross to help aid
Japan’s transformation.

“All donations made to Japan-America Society of Hawaii disaster relief efforts for
Japan will be used in
collaboration with Japanese relief organizations pursuant to charitable contribution
guidelines established by the Internal Revenue Service. Funds collected are intended
for the Japanese Red Cross Society.”

Name      

Mailing Address      

City       State       Zip Code      
Phone       Email      

Ladies tee:
Small Medium Large X-Large 2 X-Large
Quantity:
                             
Note: (please state special sizes/quantities if not listed)

Total Quantity      

x $20.00      
TOTAL DUE      
Larger quantity orders which need to be shipped, please contact us directly.

Check box that applies:

Cash due upon receipt of product.

I agree to pay above charges:

Name:       Date:     

Please email completed order form to [tiara@laakeaevents.com].

Mahalo for your support of Japan during this time of transformation…

May you continue to be blessed.

Tiara Lee-Gustilo Belden Hee