[This order form is also available in PDF format suitable for printing.]

Info-Cult T-Shirt
Order Form

Please Print

NAME:

STREET ADDRESS:
 

CITY:

PROVINCE / STATE:

COUNTRY:

ZIP / POSTAL CODE:

T-SHIRT DESCRIPTION

SIZE (S,M,L)

QUANTITY

AMOUNT *

BLACK T-SHIRT
(WHITE LETTERING
AND DESIGN)

WHITE T-SHIRT
(BLACK LETTERING
AND DESIGN)

 
 
TOTAL AMOUNT ENCLOSED:

* Enclose $25 US for the first T-shirt, and $19.00 US for each additional T-shirt.
  Canadian orders may enclose these amounts in Canadian funds.

Please make cheque or money order payable to Info-Cult:

Info-Cult
Resource Centre on Cultic Thinking
5655 avenue du Parc, Suite 208
Montreal, Quebec, Canada H2V 4H2