Merchandise Order Form

Make your selections, and submit. It's that simple.

Select Items	Price	Quantity
Golf Umbrella	$25.00
Coasters	$1.00 each
Golf Balls	$6.00
Mug	$3.25
Mouse Pad	$6.50
Notes Mouse Pad	$2.75
Pen	$3.50
Polo Shirt - S	$22.00
Polo Shirt - M	$22.00
Polo Shirt - L	$22.00
Polo Shirt - XL	$22.00
Goodie/Gift Bag	$.75
Note Pads - lot of 25	$307.00
Note Pads - lot of 50	$380.00
Note Pads - lot of 100	$483.00

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Securities offered through Prime Capital Services, Inc (PCS). Member FINRA/SIPC Investment Advisory Services offered through Asset & Financial Planning, LTD. (AFP), Gilman Ciocia, Inc., Prime Capital Services, Inc., and Asset & Financial Planning, LTD. are affiliated entities. PRIVACY STATEMENT