mgrlogo
Myotonic Goat Registry
3174 Valley Ford Road, Adger, AL 35006
Phone: 205-425-5954
Email: myotonicgoatregistry@yahoo.com

Forms © Myotonic Goat Registry

Please fill in this form in its entirety, failing to do so will result in the MGR not being able to complete your requested paperwork. We currently accept MasterCard, Visa, Discover, and American Express.
Minimum purchase of $20.00 is required for Credit Card use. For security purposes Credit Cards via mail or telephone only. Be advised, NSF check return fee (bounced check) $30.00.

This form will print out in two pages!
Merchandise Purchases
Quantity
Price Per Item (S&H included)
Amount Total
Embroidered Olive Caps
x
$15.00 ea.
$
Embroidered Pink Caps
x
$15.00 ea.
$
Embroidered MGR T-shirts
Now available in two colors!
Small - Red
x
$12.00 ea.
$
Medium - Red
x
$15.00 ea.
$
Large - Red
x
$15.00 ea.
$
X-Large - Red
x
$15.00 ea.
$
2X-Large - Red
x
$18.00 ea.
$
3X-Large - Red
x
$18.00 ea.
$
4X-Large - Red
x
$18.00 ea.
$
Small- Gray
x
$15.00 ea.
$
X-Large - Gray
x
$15.00 ea.
$
MGR Logo Decal - Chrome
x
$6.00 ea.
$
MGR Car Tag
x
$10.00 ea.
$
MGR Sign -Fainting - with logo
x
$25.00 ea.
$

Other:

x

 

 $

Total

 $


Please enter your complete Name & Shipping Address here (Please include this whether you're using a credit card or not)


The following section is for Credit Card Purchases only
Card Holder’s Name (as printed on card):
Complete Address:
Type of Card: Credit or Debit Card:
Credit Card Number: Expiration Date:
Credit Card Identification Number (Three digit code on back of card):
Total Transaction Amount: $
Authorized Signature:______________________________
Use your browsers print button or the button below