Please Print & Fill Out Form and Return with Check / Money Order to the Following Address:

DIRT DUDS
ATT: NATHAN
621 FALLS RD.
MONTEREY, TN 38574

Please Make Checks/Money Orders Payable to: Dirt Duds

*** Please Allow 2-3 Weeks Delivery Time ***
NAME:(Please Print)______________________________________________________________
ADDRESS:______________________________________________________________________
CITY:________________________________________STATE_________ZIP:_______________
DAYTIME PHONE:________________________EVENING PHONE______________________
EMAIL ADDRESS:_______________________________________________________________

2010 KINZER AUTISM TEE (ICE GRAY)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Kinzer Autism Tee (Ice Gray)      
Size Small
 $20.00 each __________ __________
Size Medium
 $20.00 each __________ __________
Size Large
 $20.00 each __________ __________
Size XL
 $20.00 each __________ __________
Size 2XL
 $20.00 each __________ __________
Size 3XL
 $20.00 each __________ __________
Size 4XL
 $20.00 each __________ __________

2010 KINZER AUTISM LONG SLEEVE SHIRT (GRAY)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Kinzer Autism Long Sleeve Shirt (Gray)      
Size Small
 $25.00 each __________ __________
Size Medium
 $25.00 each __________ __________
Size Large
 $25.00 each __________ __________
Size XL
 $25.00 each __________ __________
Size 2XL
 $25.00 each __________ __________
Size 3XL
 $25.00 each __________ __________
Size 4XL
 $25.00 each __________ __________

2010 KINZER AUTISM HOODED SWEATSHIRT (GRAY)

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Kinzer Autism Hooded Sweatshirt (Gray)      
Size Small
 $30.00 each __________ __________
Size Medium
 $30.00 each __________ __________
Size Large
 $30.00 each __________ __________
Size XL
 $30.00 each __________ __________
Size 2XL
 $30.00 each __________ __________
Size 3XL
 $30.00 each __________ __________
Size 4XL
 $30.00 each __________ __________

2010 KINZER HEADWEAR

DESCRIPTION PRICE QUANTITY TOTAL $
2010 Kinzer #18 Various Hats / Beanies      
Stone #18 Hat
 $20.00 each __________ __________
Black #18 Hat
 $20.00 each __________ __________
Torn Camo #18 Hat
 $20.00 each __________ __________
Black #18 Beanie
 $20.00 each __________ __________
Black w/ Stripes #18 Beanie
 $20.00 each __________ __________
Pink #18 Beanie
 $20.00 each __________ __________
Camo #18 Beanie
 $20.00 each __________ __________

VARIOUS 2010 KINZER MERCHANDISE

DESCRIPTION PRICE QUANTITY TOTAL $
Various Brandon Kinzer Merchandise      
1:24 Scale 2010 World 100 Car
 $85.00 each __________ __________
1:24 Scale 2010 Regular Car
 $75.00 each __________ __________
Kinzer #18 Mini-Door
 $20.00 each __________ __________

SHIPPING & HANDLING

Please Add $7.00 S&H to your Amount Totals
$7.00

GRAND TOTAL

Please Add all Total Amounts + Shipping & Handling __________
KINZER MOTORSPORTS & DIRT DUDS ARE NOT RESPONSIBLE FOR LOST ORDERS OR MERCHANDISE. PLEASE SEND ONLY CHECKS OR MONEY ORDERS WITH YOUR PRINTED ORDER FORM. THANK YOU FOR YOUR SUPPORT OF KINZER MOTORSPORTS!!!