Please enter the following information:

Merchandise	PLEASE CHOOSE ONE MDIAI Patch MDIAI Pin MDIAI Jacket MDIAI Shirt
Quantity	1 2 3 4 5 6 7 8 9
Size	M L XL PLEASE CHOOSE ONE
Merchandise	PLEASE CHOOSE ONE MDIAI Patch MDIAI Pin MDIAI Jacket MDIAI Shirt
Quantity	1 2 3 4 5 6 7 8 9
Size	M L XL PLEASE CHOOSE ONE

 

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Choose one of the following payment options:

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We do not currently accept credit cards.

Please add $2.00 to your total  to cover shipping and handling for patches and pins.

Please add $5.00 to your total to cover shipping and handling for jackets and polo shirts.

You may choose to print this form and submit the printout, along with payment, to:

Heather McNeill, Treasurer
Ron Smith and Associates, Inc.
Post Office Box 670
Collinsville, Mississippi 39325

           OR

Click the "Submit" button below which sends your above information to the MDIAI Treasurer.  You may then follow up with payment, or contact by e-mail for other arrangements or questions.