Victoria MG Club ... Regalia Request Form

Please type the required information into the appropriate fields and 'print' the form using your computer.

Regalia Order:

Quantity
Description
Amount
Size
Please note that there is no regalia currently available
 
 
Subtotal (Canadian Funds) =
 

Shipping Address:

Shipping Address (if different from the Membership Application Form)
First Name:
Last Name:
Spouse or Partner's Name:
Street Address (Line 1):
Street Address (Line 2):
City:
Province / State:
Postal Code / Zip:
Country:

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