Service Providers

(213) 749 - 1809

Fax Your Order today.

Fax (213) 748 - 5766

 

Name_________________________________________

Company ______________________________________

Address _______________________________________

City __________________________________________

State ______ Zip ______________

Phone (        )_________________________________

 

Style Preferred: ________________ Color: ________

Shoe Size: _____________ ( wide)   (narrow) Color: _____

 

Measurements:

 

Coat:

Coat Size: __________ Sleeve Inseam _______________  Chest: ________

 

Pants:     Out seam _______  Inseam ________________

                Waist __________  Hips _________

 

Height: __________ Weight: _________

 

Special Instructions / Comments: ___________________________________

_______________________________________________________________

 

Payment Method: __________________________________________

 

(213) 749 - 1809

Fax Your Order today.

Fax (213) 748 - 5766