Order Total:$

PELHAM GARDENS MIDDLE SCHOOL 2545 Gunther Avenue-Room 426 Bronx, New York 10469 Phone: (718) 794-9750 Fax; (718) 794-9756 Denise L. Williams, Principal Joseph Biernat, Melissa Dellipaoli, Ian McGhie ~ Assistant Principals

School Uniform-Order Form

Payment must be submitted with order. Please enter the quantity of each item in the box labeled “Qty” under the appropriate size for your child. Item

Child XL Size 28-30

Qty Polo Shirt Short Sleeve

Qty $10

Qty Sweatshirt Crew

Adult Small Size 28-30

Qty $10

Qty $15

Adult Medium Size 32-34

Adult XL Size 40-42

Adult 2XL Size 44-46

Qty

Qty

Qty

$10

Qty $15

Adult Large Size 36-38

$10

Qty $15

$12

Qty $15

Total

$15

Qty $17

$20

Order Total: $ STUDENT INFO Student’s Name: __________________________________________ Class: __________________________________________________ PARENT INFO Parent’s Name: ___________________________________________ Phone Number: ___________________________________________ Email: __________________________________________________

Contact Parent Coordinator Mr. Leader at [email protected] if you have any questions or concerns. Thank you.