Show Your Support for HEATŽ


	Show Your Support for HEATŽ HEATŽ t-shirts and polo shirts are available for purchase. Just complete the form below, print, and mail to: MAIPF Attn: HEATŽ-Wear 17177 Laurel Park Drive N. Suite 243 Livonia, MI 48152

All checks should be made payable to the Michigan Auto Insurance Placement Facility (MAIPF). Please allow six weeks for delivery. All prices include tax, shipping and handling.

Use TAB to move throughout the form

White Polo Shirts with embroidered HEATŽ logo in color (indicate quantity desired):

Small - $22.00
Medium - $22.00
Large - $22.00
XL - $22.00
XXL - $24.00
XXXL - $26.00

White T-shirts with silkscreened HEATŽ logo and phone number in color (indicate quantity desired):

Small - $11.00
Medium - $11.00
Large - $11.00
XL - $11.00
XXL - $14.00
XXXL - $15.00

I am excited to show my support for HEATŽ!

Please send my shirt(s) to:

First name

Last name

Address 1 No P.O. Boxes Please

Address 2

City

State

Zip Code

Phone (with a/c)

E-mail Required for confirmation page to print.

Amount of Check Please make the check payable to the MAIPF

Comments

Thanks for showing your support!

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Š MAIPF 1999 - cb Last updated 3/2/01 Please forward comments and suggestions to the site’s webmaster.


First name
Last name
Address 1	No P.O. Boxes Please
Address 2
City
State
Zip Code
Phone (with a/c)
E-mail	*Required for confirmation page to print.*
Amount of Check	*Please make the check payable to the MAIPF*
Comments

Show Your Support for HEATŽ

HEATŽ t-shirts and polo shirts are available for purchase.

I am excited to show my support for HEATŽ!

Please send my shirt(s) to:

Thanks for showing your support!