Robe Order Form
Billing Address
Name:
Address:
City:
State:
Zip Code:
Country:
Phone #:
Fax #:
E-mail Address:
Mailing Address (if different)
Name:
Address:
City:
State:
Zip Code:
Country:
Credit Card Information
Which type of Credit Card will you be using?
Visa
MasterCard
Card Number:
Name on card:
Card Expiration Date:
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
Item List
Quantity
Style
Description
Price Each
Total
For each item ordered above, be sure to include size, color and fabric, as appropriate. Indicate all colors, including the color of cords around velvet as well as the velvet and robe colors. For hoods, please provide lining (school) colors, indicating which color is the field (large part) and the chevron (narrow stripe). For tams, indicate number of sides and size. Tell us if you want the standard rayon tassel or the handmade gold bullion tassel.
Sub-Total
8.25% tax for
CA only
Shipping
Grand Total
Measurements
I wear Suit/Dress size:
My shirtsleeve length is:
inches.
My total height is:
