Dazzling Pageant Embroidery Order Form



Please Cut and paste and send to
Pmsewell@embarqmail.com
Ship To:

Name:

Address:

City:

State:

Zip Code:

Phone Number:

e-mail address:

paypal Address:


Please tell us how you found  us or who referred you.


Date of event:
Quantity

item #

color of center:

color of trim:

Design/crown # on shoulder:

Text/wording on shoulder:

text/lettering color:

font #

Wording on front:            1st line
Item # 1 &  3                    2nd line

Unit Price

Special Instructions
Type of payment:  please indicate one.
Paypal   Money Order   checks only accepted from established customers and will be held 10 days after
receiving and before order started.
Please be aware that we do not start any orders till
order is paid. Once order is cut and embroidery
started there are no refunds the order is yours.
Thank you for your understanding about this policy.