Designed Especially For You
Order Form

When we receive your order, we will contact you for more details.

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$95.00	..........................Adult Size:		___ Small ___ Qty ___ Medium ___ Large ___ xLarge
$75.00	..........................Child Size:		___ Small ___ Qty ___ Medium ___ Large
	Preferred Color(s):		________________________________________
	Lining:		________________________________________
$10.00	...................Special Lining:		________________________________________
$20.00	.......................Metal Frogs:		___ Gold ___ Silver ___ (Mid measurement required)
$10.00	.......................Rush Order:		___
	Custom Requests: (What do you want?)		________________________________________
			________________________________________
			________________________________________
			________________________________________
			________________________________________
	Name:		________________________________________
	Address:		________________________________________
			________________________________________
	Telephone:		____________________ Daytime
			____________________ Evening
	E-mail Address:		________________________________________
	Payment Option:		___ Personal check ___ Cashiers check ___ Money order ___ Payment plan