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"REVOKE THE LICENSE TO KILL"
T-SHIRT ORDER FORM
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A fashionable way to support tobacco control efforts abroad and help monitor Big Tobacco's global expansion! Please print, fill out, and mail this form with a check for the appropriate amount.

Size      Quantity                 Subtotal

XL         _____

L           _____

M          _____

S          _____

Total # _____ x $19.99 = ______

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Additional donation         $______
(entire amount will
go to support global
monitoring of industry)

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Shipping & Handling

Total # of    Shipping
t-shirts          Cost*

_____    x   $_____   =   $______

* RATES
# of shirts     cost per shirt

  1 - 5              $2.50
  6 - 10            $2.00
  11 <               $1.50

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GRAND TOTAL:                  $______

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SHIPPING ADDRESS

Name: ___________________________

Address: _________________________

City: ____________________________

State: ___________________________

Zip Code: ________________________

Email: ___________________________

Tel: _____________________________

Please make checks payable to:
"ESSENTIAL INFORMATION"

Order form and checks should be sent to:

Attn: Anna White
Global Partnerships for Tobacco Control
Essential Action
P.O. Box 19405
Washington, DC 20036

NOTES:
1) All money received -- minus the actual costs of t-shirts, shipping, and handling -- will help fund small grants to tobacco control advocates in low-income countries for tobacco industry monitoring projects, including photo documentation of tobacco marketing and promotional strategies.

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THANK YOU FOR SUPPORTING GLOBAL TOBACCO CONTROL EFFORTS!
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