Keystone Uniform Cap
(215) 821-3434 DIVISION OF M. H. GROSSMAN fax (215) 821-3438
2251 Fraley Street
Philadelphia, PA 19137
Manufacturers of Quality Uniform Headwear
Military Order Purple Heart – Cap Order Form
City: State: Zip:
Phone# Cap Size:
**The Men’s style cap includes the words, “Military Order Purple Heart”
and the MOPH patch.
Item Description Units Price Extension
National All white with purple $22.75 ea.
Cap letters and purple trim
Department White top with purple $22.75 ea.
Cap sides, gold trim and white
Chapter All purple with white $22.75 ea.
Cap letters and white trim
*see below Includes Chapter#
Life Includes direct embroidery $5.00 ea.
Member around flap curve on front
Annotation right side
Additional (Do not count punctuation $.50 per
Letters marks) letter
Zippered Frosty clear plastic bag $3.50 ea.
Shipping & $7.50
for 1 item
All orders are paid in advance with check or money Total:
order. Checks payable to: Keystone Uniform Cap
*Please include your Chapter#: Embroidery on Right side of
(only for Chapter caps) Cap