D ATE ________________ S EASON _________________
SHIP TO:
O RDER N O . ____________ S HIP V IA _________________
Suzi Jacobson: p) 312-890-9639
[email protected] | www.mamasoozematernity.com
S HIP D ATE _____________ C OMPLETE ________________
Cathe Verdusco: p) 213-892-0779 f) 213-892-0212
[email protected] | www.westcoastmaternity.com
T ERMS ______________________________________
BILL TO:
C ONTACT N AME _________________________________
MANUFACTURER:
P HONE ________________ FAX ___________________
32
STYLE NO.
TOTAL
SPECIAL INSTRUCTIONS:
COLOR
DESCRIPTION
P
4
34
S
6
36
M
8
38
L
10
40
42
44
XL XXL
12 14 16
46
1X
18
48
2X
20
50
3X
22
52
4X
24
26
UNIT
COST
TOTAL