BHQ Jersey Order Form

Shirt Style	Shirt Size	Quantity



Short Sleeve $54.99 Long Sleeve $59.99 Hoodie $74.99

Please fill in the blanks according to the shirt diagrams. Click on the image to the right for a larger view. Please call (815)-513-5583 with any questions.

Front Name

Back Name

Include 1/4 Zip Collar $5.00 additional (not available on hoodie)

Include Water Resistant Option $30.00 additional (available on hoodie ONLY)

Special Instructions (add your style number here):

Your Contact Information
(We will contact you for payment info.)


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Name:*
Address:*
City:*
State:*
Zip:*
Phone:*
E-Mail:*

(Please only hit the Submit button once)

Click on the image to the right for a larger view. Please call (815)-513-5583 with any questions.

Click on the image to the right for a larger view.
Please call (815)-513-5583 with any questions.