Louisiana Destination Imagination

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    State Tournament Team Registration & T-shirt  Order Form

    This form and T-shirt payments are due for each team on Saturday, Jan 23, 2016.
    You may submit this form on-line and bring payment to Super Instant Challenge Saturday, or mail payment to Nancy Farley, J.S. Clark Magnet School, 1207 Washington Street, Monroe, LA  71201.  Don't forget to order for parents & supporters too!

    Please use normal capitalization, i.e., no ALLCAPS HIGH or e.e.cummings elementary, please.
    Do not include "School" as part of your school's name. E.g., "Howard Elementary," or "Bart Simpson High." Please make sure you use the same exact spelling/wording for all the teams at your school--thank you :)
    You must have registered with Destination Imagination, Inc., through shopdi.org in order to have a DI Membership Number.
    Enter the best phone number for contacting your school's primary LA DI point of contact after school/during evening hours.

    Louisiana State Tournament T-shirt Orders
    Enter number needed for each size and calculate cost for each size

    Enter the number of Youth Small Size T-Shirts needed.

    x $15          =
    Multiply the number of Youth Small T-Shirts times $15 and enter it in this field.
    Enter the number of Youth Medium Size T-Shirts needed.

    x $15          =
    Multiply the number of Youth MediumT-Shirts times $15 and enter it in this field.
    Enter the number of Youth Large Size T-Shirts needed.

    x $15          =
    Multiply the number of Youth Large T-Shirts times $15 and enter it in this field.
    Enter the number of Adult Small Size T-Shirts needed.

    x $15          =
    Multiply the number of Adult Small T-Shirts times $15 and enter it in this field.
    Enter the number of Adult Medium Size T-Shirts needed.

    x $15          =
    Multiply the number of Adult Medium T-Shirts times $15 and enter it in this field.
    Enter the number of Adult Large Size T-Shirts needed.

    x $15          =
    Multiply the number of Adult Large T-Shirts times $15 and enter it in this field.
    Enter the number of Adult XL Size T-Shirts needed.

    x $15          =
    Multiply the number of Adult XL T-Shirts times $15 and enter it in this field.
    Enter the number of Adult 2XL Size T-Shirts needed.

    x $17         =

    Multiply the number of Adult 2XL T-Shirts times $16 and enter it in this field.
    Enter the number of Adult 3XL Size T-Shirts needed.

    x
    $16          =
    Multiply the number of Adult 3XL T-Shirts times $16 and enter it in this field.
    Add all the amounts for each size T-shirt size.
    Orders and payments are due NLT Saturday, Jan 23, 2016.

    Make checks out to LA DI


    Mail or deliver checks to:

    Nancy Farley
    J.S. Clark Magnet School
    1207 Washington Street
    Monroe, LA  71201

    Print this page for your records prior to submitting

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