PLEASE TYPE IN UPPER CASE LETTERS

Your Information

First Name*

Last Name*

Shipping Address*

Address Line 2

City*

State*

Zip Code*

Phone Number*

Email*

Date of Recital*

Name of Studio*

Order Your Gifts

Item#1

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Item#2 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Item#3 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Item#4 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Item#5 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Item#6 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Item#7 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Item#8 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Item#9 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Item#10 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Select the Color of the Bear from dropdown

Personalization Embroidery* Do you want to add free Embroidery to your Bear?
 Yes No

First Name of Dancer (If none leave Blank - Please type in All Caps Lettering)

Name of Studio (If none leave Blank - Please type in All Caps Lettering)

Year of Recital

Total

Total Amount for Gifts:*

Payment

Payment Method*

Name on Card*

Card Number*

Exp. Date*

CSC* (3-Digit Security Code on back of card)(American Express Card holders please put your 4-Digit code from the front of your card.)

Billing Address*

City*

State*

Zip Code