USA Order Form

From Unicycling Society of America

Product	Quantity	Price	Cost
Single Back Issue: Vol: ____ No: ____	__________	$4.00*	________
Complete Set of all Issues (1974-1993)	__________	$70.00*	________

Product	Quantity	Price	Cost
4" Embroidered USA Inc. logo	__________	$2.50*	________
USA Skill Level Patches and Cards	__________	$1.50*	________

Rider_____

Level 1_____

Level 2_____

Level 3_____

Level 4_____

Levels 5-10 may be ordered only by an official Skill Level tester.

Product	Quantity	Price	Cost
Unicycle Charm - Sterling Silver	__________	$5.50*	________
Unicycle tie tack (pin) - Gold Plated	__________	$5.00*	________

Product		Quantity	Price	Cost
IUF Skill Levels	(domestic)	__________	$23.50*	________
	(foreign)	__________	$32.00*	________

Product	Quantity	Price	Cost
Acrobatics Book	__________	$5.95	________
Juggling	__________	$14.00	________
Learning to Ride from Semcycle	__________	$2.50*	________

(no charge if price includes *)

Allow 6-8 weeks for delivery of all items.
Make all checks or money orders payable to:

Unicycling Society of America, Inc.
PO Box 530518
Livonia, MI 48153-0518

Name_________________________________________________________________________

Address______________________________________________________________________

City____________________________________________ State________ Zip__________