Please refer to the How to Order section before completing this form. The How to Order section explains the entire order process, including payment and shipping.

----------------------------------------------------- PERSONAL INFORMATION -----------------------------------------------------

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*First Name:

*Last Name (Family Name):

*E-mail:

*Address Line 1:

Address Line 2:

*City:

*State: [Choose State] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [Outside of USA]

*Zip/ Postal Code:

*Country:

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--------------------------------------------------------- ITEM INFORMATION ---------------------------------------------------------

*Size: [Select Size] S M L XL XXL

	*Main Color:	*Accent Color:
*Fabric Color:	[Select Color] Antique Banda Blue Black Blue Shadow Bronze Burgundy Celery Claret Cobalt Cocoa Copper Cream Dark Denim Denim Grey Hunter Indigo Khaki Lavender Lipstick Light Blue Mauve Mojave Gold Monaco Blue Mulberry Navy Peach Plum Purple Russet Scarlett Sea Green Solid Water Spray Green Sun Tan Taupe Teal Vineyard White Wild Grapes Wine	[Select Color] Antique Banda Blue Black Blue Shadow Bronze Burgundy Celery Claret Cobalt Cocoa Copper Cream Dark Denim Denim Grey Hunter Indigo Khaki Lavender Lipstick Light Blue Mauve Mojave Gold Monaco Blue Mulberry Navy Peach Plum Purple Russet Scarlett Sea Green Solid Water Spray Green Sun Tan Taupe Teal Vineyard White Wild Grapes Wine

------------------------------------------------------------------ SHIPPING ------------------------------------------------------------------

Shipping: (Standard shipping By the US Postal Service is free within the continental United States. If you desire another form of shipping, fill out the "other" box below. Shipping to areas outside of the Continental USA, or any other type of shipping other than USPS, is subject to an additional shipping charge. If you live outside of the continental USA, you may leave this section blank. I will inform you of the shipping costs when I send you a confirmation e-mail requesting payment.)

USPS (Free within the Continental USA)
Other (Please Specify)

Comments: (Please include any additonal questions/ comments you may have. I will e-mail you shortly to answer any questions.)