Please fill out the information and include you check or money order and mail to:
Sam Little
Winged Boot
P.O. Box 59
Weatherford, TX 76086
Name:________________________________________________________________________
Address:______________________________________________________________________
City:_________________________________________________________________________
State / Zip:____________________________________________________________________
Years in Survival:_______________________________________________________________
I would like ______ Winged Boots I have included $157.00 per boot ____________________
Shipping: $20.00_____________________
TAX_____________________
(Texas residents add 6.25% Tax)
Total:_____________________
I was (am) a Survival (SERE) Instructor with the US Air Force.
Signature_______________________________________________________________
Credit Card #___________________________________________________________
CC Type: MC______ VISA_____