Torch Run Materials Order/Return Form Torch Run Materials Order/Return Form Your Name* First Last Your Email* Your Department/Agency*Your Shipping Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Your Phone Number*Date of event for which materials are needed* Please choose one of the following*I am ordering materialsI am returning materialsSmall Tech Shirts (Quantity)Medium Tech Shirts (Quantity)Large Tech Shirts (Quantity)XL Tech Shirts (Quantity)XXL Tech Shirts (Quantity)XXXL Tech Shirts (Quantity)Small Cotton Shirts (Quantity)Medium Cotton Shirts (Quantity)Large Cotton Shirts (Quantity)XL Cotton Shirts (Quantity)XXL Cotton Shirts (Quantity)XXXL Cotton Shirts (Quantity)Hats (Quantity)Wells Fargo Deposit Slips (Quantity)Blank Appreciation Certificates (Quantity)Posters (Quantity)Brochures (Quantity)Banners (include event type) (Quantity)Please read and sign the following: I, as Torch Run Coordinator for my department, accept responsibility for the Torch Run T-shirts ordered. I understand that we must receive a $15donation for each cotton shirt, $20 for each tech shirt and $15 for each hat. I will be responsible for depos-iting all funds from T-shirt donations as soon as possible and will return any extra T-shirts to SONC when requested to do so.* First Last Accepted*---YesNo This form is also available for download. If you have any questions about the form, contact the NC Torch Run at (919) 719-7662.