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

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#2 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#3 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#4 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#5 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#6 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#7 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#8 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#9 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#10 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

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

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

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