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SCOPE Rewards Request Form
I would like to see the items again*
*If you filled out the form, use the"Back-Forward" feature of your browser, as the above link on some browsers will erase the entries

Depending on the amount of your donation, please select any combination of these SCOPE items:

Quantity
Description
Donation Amount
Surface
Static
$ 1 Donation = Decal
Red, White, Blue on vinyl
Please specify surface mount adhesive or inside window static
$
$10 Donation = Coffee Mug Transparent Blue Glass
$
Navy
Camo
Orange Camo 		$10 Donation = Hat Navy, Camo, or Orange Camo
  • Navy hat has full color SCOPE patch
  • Camo hat has subdued color SCOPE patch
    • $

    Small
    Medium
    Large
    XL
    XXL
    XXXL

    		 $15 Donation = T-shirt 2 sided, gold on navy blue
    $
     
    Subtotal:
    $
    Shipping and
    Handling
    Please add $4 S&H per request. Thank you.
    (Decal only orders - $1 S&H, regardless of quantity)
    $
     
    Total Donation:
    $

    All SCOPE products are proudly made in USA

    Please fill out this form, then print and mail with your check or money order payable to:

    SCOPE
    PO Box 12711
    Rochester, NY 14612

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