BHQ Jersey Order Form

Shirt Style	Shirt Size	Quantity



Short Sleeve $49.99 Long Sleeve $54.99 Hoodie $69.99

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.)


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

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.