STUDENT INFO
Last Name ..
First Name
Address
City
State
Zip
Phone
Email
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TUXEDO OPTIONS PLEASE MARK BELOW
SCHOOL NAME:
Fresh
Soph
Jr
Sr
Band
Choir
Orchestra
Option A $119
Option B $59.50
New Shirt $20
Used Shirt $15
Cummerbund $7
Bow Tie $3
New Shoes $49
Used Shoes $30
Garment Bag $15
Shoe Size
ORDER TOTAL - REMEMBER TO INCLUDE TAX 8.05%
AMOUNT TO CHARGE $:
PAYMENT CARD
VISA
MASTERCARD
DISCOVER