Caps Order Forms

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					                 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
Name:
Address:
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
                   letters
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.
Bag
Shipping &                                                           $7.50
Handling
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

				
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