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Order Form to Fax

17642 Lasiandra Dr.     Chesterfield, MO  63005-4912  
Toll Free: 1-800 421-1974     Fax:  888 530-7654 or 636 536-0722

Payment Method:  If using a purchase order from the school, you need to fax , send or e-mail it with your order. 

mastercardvisadiscoveramerican express

Credit card # _____________________________________________, Expiration date___________.

Last 3 #'s on back of credit card______________

Ship To:  
Attn:  
Address  
City, State, Zip Code  
Address where credit card statement is sent  
City, State, Zip where credit card statement is sent  
Fax #  
Day Phone  
Best time to call  
Home Number  
e-mail address  
Special Instructions  

Custom Uniforms Orders-Click Here for a sketch sheet if you're not matching a style from a catalog.

Quantity Ordered Description Unit Price $ Amount
       
       
       
       
       
       
       
       
       
       
       
       
       
       
 

 

   

Signature:_______________________________________________________________________     Date _________________________

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