All-State Team Patches
(for swimming, diving, and water polo)

All State Team Patches are available for $10.00 each
(Postage and handling included)

Please print this page and fill it out and mail it to:

All State Patch Order Form

Name ___________________________________________________

School ______________________________________________________

Address _________________________________________________

City_______________________

State_____

Zip______________

email ___________________________________________________ Phone Number _________________________________  

 

Class  (circle one)  5A            4A          Private Schools

Number of patches ordered @ $10.00 each   

________

Event Qualified  (circle event(s))

 

 

 

200 Yard Medley Relay

100 Yard Freestyle

 

 

 

200 Yard Freestyle

500 Yard Freestyle

Total amount enclosed

 

___________

200 Yard Individual Medley

200 Yard Freestyle Relay

 

 

 

50 Yard Freestyle

100 Yard Backstroke

 

 

 

One Meter Diving

100 Yard Breaststroke

 

 

 

100 Yard Butterfly

400 Yard Freestyle Relay

 

 

 

 

Water Polo

 

 

 

Terri Morse
1504 Park Street
Pecos, TX 79772

 tmorse@classicnet.net

Make Checks payable to: TISCA

Class 4A, 5A and Private School TISCA All State Patches