St. Augustine Church & Catholic Student Center
             Alpha 30th Anniversary
      Commemorative T-shirt Order Form
                     (and contact update)

Cost: $12 per shirt + $5 shipping fee = $17 per shirt (if shipped)

Drop-off or mail your payment to:
St. Augustine Church - 1738 W. University Ave. Gainesville, FL 32604.
You can then pick-up your shirt(s) or  we will ship your shirt(s) to you:

I would like my shirt(s) shipped to me.
      I will mail my payment of $
 
I will arrange for my shirt to be picked up at St. Augustine Church
      At that time, I will drop-off my payment of $

Note about sizes: We currently have a good number of Large and XL shirts in stock. If you order shirts of another size, please allow up to a month or so for us to mail it to you because we will be
re-ordering shirts from the printer based on the # of shirts reserved by alumni.

Please type the # of T-shirts you would like to purchase next to the size(s):

Small: Medium: Large: XL:

Last Name   First Name   

E-mail address

Candidate Alpha Semester/Year:

Graduation Year & Degree:

Did you ever serve on Alpha Team?

No  Yes, Semester/Year(s):

Did you ever serve as a Team Leader?

No Yes, Semester/Year(s):

Mailing/Shipping Address:

Address City State   Zip

Home Phone    Cell Phone   Work Phone

D.O.B.  (mm/dd/yyyy)  Ethnicity                 

Marital Status Single Married Widowed Separated Divorced    Address Preference None Mr. and Mrs. Ms. Mr. Dr. and Mrs. Mr. and Dr. Drs.    

Occupation    Employer  

In addition to Alpha, what were you involved in at St. Augustine?

Spouse Information:

Last Name   First Name    E-mail address

Candidate Alpha Semester/Year:

Graduation Year & Degree:

Did you ever serve on Alpha Team?

No  Yes, Semester/Year(s):

Did you ever serve as a Team Leader?

  No Yes, Semester/Year(s):

Cell Phone   Work Phone

D.O.B.  (mm/dd/yyyy)  Ethnicity                 

Address Preference None Mr. and Mrs. Ms. Mr. Dr. and Mrs. Mr. and Dr. Drs.     Occupation    Employer  

Was your spouse also involved at St. Augustine? If so, in what way?

Children:

Child 1

Name        Sex Male Female     DOB (mm/dd/yyyy)

Child 2

Name        Sex Male Female     DOB (mm/dd/yyyy)

Child 3

Name        Sex Male Female     DOB (mm/dd/yyyy)

Child 4

Name        Sex Male Female     DOB (mm/dd/yyyy)

Child 5

Name        Sex Male Female     DOB (mm/dd/yyyy)

I would like to receive the Take and Read Newsletter:

By Mail   OR    By E-mail

I would like to learn how I can contribute to the Student Center:

Feel free to share some news
or comment on your experience at St. A's: