The Official AMC 4K Patch Order Form

~ Patches are for List Finishers Only ~

Please circle the patch you want and note the quantity.

WM4K Qty. ________ @ $4 each = ___________

WM4K Winter Qty. ________ @ $4 each = ___________

NE4K Qty. ________ @ $4 each = ___________

NE4K Winter Qty. ________ @ $4 each = ___________

NE100 Highest Qty. ________ @ $4 each = ___________

NE100 Highest Winter Qty. ________ @ $4 each = ___________

The 111 (a.k.a. The 115) Qty. ________ @ $4 each = ___________

TOTAL AMOUNT ENCLOSED $________________

(The $4 per patch price includes shipping and handling.)

Make Checks Payable to AMC Four Thousand Footer Committee

Mail to AMC Four Thousand Footer Committee

PO Box 444

Exeter, NH 03833-0444