Contact Information: All Fields Required
Name:
Email:
Phone:
Address:
City:
State:
Zip Code:
Credit Card Information: All Fields Required
Card Holder's Name:
Card Name:
Card Number:
Expiration:

Order Type: Check All That Apply
Costume		Bra & Belt Set		Veil
Necklace		Earrings		Sleeve/Glove
Skirt		Hip Scarf/Sash		Footlet/Wristlet
Video		Music		Gift Certificate

Measurements:
Dress Size		Bra Size		Cup Size
Sleeve Length		Inseam Length		Skirt Length
Upper Arm Measurement		Wrist Measurement		Ankle Measurement
Hip Size		Neck Size		Head Size

Please note that in order to complete your online order, you must enter an amount in the box labeled "Price" for each item specified. All items should be totaled at the bottom of form (sub total). All applicable shipping charges and taxes should be entered in the appropriate boxes, and then added together for a total amount at the bottom of the form.

Order
Item One:
Item Description:
Reference #:
Preferred Color:
Second Choice:
Price:
Item Two:
Item Description:
Reference #:
Preferred Color:
Second Choice:
Price:
Item Three:
Item Description:
Reference #:
Preferred Color:
Second Choice:
Price:
Item Four:
Item Description:
Reference #:
Preferred Color:
Second Choice:
Price:
Sub-Total:
Total Shipping:	(for shipping chart and information: Shipping
Applicable Tax:
Total:

Comments or special instructions: