[Print this page; fill out the form; then mail to the address at the bottom.]

Canopus Ship’s Store Order Form

Item	Price	Qty	Total
Knit Shirt Sizes: Medium – Large - XLarge	27.00
Size: 2XL	31.00
Size: 3XL	32.00
Association Challenge Coin	12.00
Association Keychain	12.00
Command Cap	17.00
License Plate Frames	8.00
Ship’s Patch	6.00
Canopus Walkthrough DVD	15.00
Add $5.00 for shipment by optional priority mail ........................
Total Order:

Please make payment to the USS Canopus Association.

Send to:

USS Canopus Association

                   c/o Richard Retin

2245 Wintercreek Way SE

                   Salem, OR 97306

All profits help pay for the ongoing costs for maintaining

the website and holding future reunions.

Send to:     ____________________________________

  ____________________________________

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