Scroll to the bottom of this page for the order form.

IMPORTANT: All blue shirts will include the ‘Intersperse’ logo and waveform. ALL other shirts will have the RS Medical logo.

Style 1 - Ladies Polo

Style 2 - Ladies Long Sleeve Polo

Style 3 - Men's Polo

Style 4 - Men's Pullover

You may order up to 3 shirts of any combination. Please submit your order before Wednesday, February 12th.

I will do everything within my control to get the correct size and color, but if the color you’ve requested isn’t available, I’ll contact you with options.

Name

First Name

Last Name

Shirt #1

Enter the style (1-4), color, and size

Shirt #2

Enter the style (1-4), color, and size

Shirt #3

Enter the style (1-4), color, and size