My Confirmation Day

ORDER FORM
FAX ORDER TO: 763-488-9700
CALL TOLL FREE AT 1-866-998-0014 (OR)
MAIL ORDER WITH CHECK TO: 10795 93RD AVE. N., MAPLE GROVE, MN 55369
Please allow three weeks processing time for orders paid with a check. Please allow two weeks processing
time for orders faxed to us with the credit card information complete.
CHURCH NAME ______________________________________________ E-MAIL____________________________________
DIRECTOR/CONTACT ____________________________________________________________________________________
ADDRESS_________________________________________________________________________________________________
CITY ________________________________________ STATE__________________________ ZIP _______________________
PHONE (

) _____________________________ DATE OF CONFIRMATION __________________________________

ADFADSF

PLEASE MEASURE THE HEIGHT OF EACH STUDENT WHILE THEY ARE WEARING THE SAME
SHOES THAT WILL BE WORN FOR THEIR CONFIRMATION.

GOWN COLOR

42

45

48

51

54

57

60

(W) WHITE
(RE) RED

49
to
411

51
to
52

53
to
55

56
to
58

59
to
511

60
to
62

63
to
65

TOTAL
QTY.

UNIT
PRICE

TOTAL

$13.95
OPTIONAL SATIN STOLES

$7.95

CREDIT CARD INFO

Check One:

Visa Master Card American Express Discover

SUBTOTAL

Card Number: ______________________________________

Name On Card: _____________________________________

SHIPPING
(W / PURCHASE OF 10 GOWNS)

Security Code: ______________________________________

Expiration Date: ____________________________________

TOTAL ENCLOSED

FREE