| QTY Sub-total | |
| Special membership package with fashion option (hat included) | _____ @ $23.95 = _________ |
| Basic membership package (hat not included) | _____ @ $15.00 = _________ |
| Official C.B.D.A. Hat | _____ @ $15.95 = _________ |
| Shipping charges add $5.00 | = _________ |
|
(orders over $50.00 shipped postage free) |
|
| TOTAL = _________ |
|
|
I am of legal drinking age: Yes ___ No ___ |
|
Name |
________________________________________ |
|
Address |
________________________________________ |
|
City/Town |
________________________________________ |
|
Province |
________________________________________ |
|
Postal Code |
________________________________________ |
|
Name to appear |
________________________________________ |
|
on certificate |
(If different from above eg. nickname) |
Please make cheques or money orders payable to Canadian Beer Drinkers’ Alliance Ltd.
Send orders to : Canadian Beer Drinkers’ Alliance, Box 877, Sutton West, Ontario L0E 1R0.
Postage may be higher for orders outside Canada. Please allow two to four weeks for delivery.