Glenview Stars Coins Order Form

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Name______________________________________________ Address_____________________________________________ City_______________________ State_____ Zip Code_________ Player's Name_____________________________ Number______ Team______________________

Make checks payable to: Glenview Stars Hockey Association 1851 Landwehr Rd. Glenview, IL. 60026 For any questions, e-mail Al Fushi at: [email protected] $18.00 each, 2 or more $15.00 each Number of coins ordered___________ = ___________ Postage $2.00 (Coins can be picked up at the rink for no fee) Total___________________