National Socialist Movement  Order Form - For Mail-in Orders

Your Name: ____________________________________________________

Your Address: _________________________________________________
      
              _________________________________________________

              _________________________________________________

Your Email: ___________________________________________________

Phone Number __________________________________________________

Your email address or phone number will enable us to contact you 
quickly if we have any queries about your order.

Item #   Item Name          Price       Quantity      Subtotal

_____    ________________   $________ x  ______  = $_________

_____    ________________   $________ x  ______  = $_________

_____    ________________   $________ x  ______  = $_________

_____    ________________   $________ x  ______  = $_________

_____    ________________   $________ x  ______  = $_________

If possible, please list an alternative below if your first choice 
is not available. 

_____    ________________   $________ x  ______  = $_________

_____    ________________   $________ x  ______  = $_________

                                       Subtotal  = $__________

Shipping - Free in US and Canada.  Outside US and Canada:  $6.00 for 
one or two items, $9.00 for three items, $12.00 for 4 or more items.  
(So, minimum shipping outside US and Canada is $6.00 and maximum 
shipping is $12.00.)
           Plus Shipping (free in US & Canada)   =   $___________
                                                                                                                                              Total   =   $___________

Send Cash, Check, Money-Order; make payable to: 
National Socialist Movement, 
P.O. Box 13768 
Detroit, MI. 48213
(We would really appreciate it if you could add a small donation to 
further the work of the Movement)