NAIVE Program
Please fill out this NAIVE Program Merchandise Order Form and submit it with your donation to: NAIVE Program P. O. Box 55 Langhorne, PA 19047
NAME: _____________________________________________ ADDRESS: __________________________________________ Number and Street __________________________________________ State and Zip Code EMAIL ADDRESS: ___________________________________ Item(s) Requested (Please fill in quantity for each item): _____ NAIVE Program Pin(s) - a $15.00 Donation for each is enclosed
Thank you again for supporting the NAIVE Program! Please allow 6 to 8 weeks for delivery.
