Miss SAU T-Shirt Fundraiser Name(Required) First Last Phone(Required)Email(Required) Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Miss SAU T-Shirt Price: Size(Required)SmallMediumLargeXLarge2XL3XLQuantity of Shirts(Required)If ordering multiple shirts and you would like to have a mixture of different sizes, please include those size details below.If you want multiples of the selected size above only, you may leave this field blank.Total Credit Card(Required) DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name CAPTCHAThis field is hidden when viewing the formTransaction IDThis field is hidden when viewing the formDateThis field is hidden when viewing the formDescriptionThis field is hidden when viewing the formCodeCommentsThis field is for validation purposes and should be left unchanged. Δ