USS America Order Form
Note: If you are in Florida, enter y in the Qnty column
to the right of Florida Residents Add 6.5% Sales Tax.
      Item Qnty Cost Each Ext
    Zippo Lighter $24.95
    Commemorative Coin $12.00
    Coin Presentation Case $6.00
    America Patch $10.95
    Sub-Total    
    Florida Residents 6.5% Sales Tax
    Shipping $4.60    
    Total    
   
Ship to:
Name:
Company:
Address1:
Address2:
City, State, Zip:
Phone:
Email address:

Be sure above is correct. Print and mail this form and check for full amount to:
USS AMERICA MUSEUM FOUNDATION
10 Summit Avenue
Butler, NJ 07405
Please allow 2 to 3 weeks for delivery.