Academic Dress purchase form

CSU Online Shop
Building 460
Valder Way
Charles Sturt University
Wagga Wagga NSW 2678
Tel: +61 2 6933 4980
Email: [email protected]
www.csu.edu.au/online-shop
ACADEMIC DRESS ORDER FORM
If you wish to hire a gown for your graduation ceremony please email the Graduation Team at
[email protected]. We do NOT offer a gown hire service.
For more details, see:
For enquiries/orders:
Website: www.csu.edu.au/online-shop
Email: [email protected]
(PLEASE PRINT CLEARLY)
Name:
________________________________________________
Student I.d. or D.o.b.: ________________________________________________
Award/Degree/Faculty:________________________________________________
Mobile Phone:
________________________________________________
Email:
________________________________________________
Delivery/Postal address:_______________________________________________
Please circle the items you wish to purchase:
Assoc Degree,
Diploma,
Univ Certificate
$195.00
N/A
N/A
N/A
N/A
$80.00
Purchase Options
Gown (poly ester)
Trencher (solid cap)
Trencher (souvenir)
Bonnet
Hood
Stole
Bachelor
$195.00
$80.00
$20.00
N/A
$95.00
N/A
Grad Cert/Dip,
Postgrad
Cert/Dip
$195.00
$80.00
$20.00
N/A
$100.00
N/A
Please complete the size and cost options:
Item
Type
Master
$250.00
$80.00
$20.00
N/A
$110.00
N/A
Size
PhD
$375.00
N/A
N/A
$125.00
$110.00
N/A
Prof
Doctorate
$395.00
N/A
N/A
$125.00
$135.00
N/A
Cost
(please circle)
Gown
N/A
Size – Your height in centimetres (cm)
Hood
N/A
Trencher
Size – Your head-size in centimetres (cm), measure
around head from just above the eyebrows
Bonnet
Size – Your head-size in centimetres (cm), measure
around head from just above the eyebrows
Postage (within Australia)
Hood or Souvenir Trencher Only – $10
All other – $20
$
N/A
$
Solid Cap / Souvenir
$
N/A
$
Please check for postage
rates outside Australia
N/A
International postage – please email for a quote.
$
TOTAL
COST:
$
Office Use Only
Date Order Received
_____________________
Received By Staff Member_____________________
Date Customer Quoted_____________________
Date Staff Ordered
_____________________
Order Number
_____________________
Customer Delivery Date
______________________
Confirmation email
_____________________
Delivery Email
______________________
Tracking Number
______________________
CSU Online Shop
Building 460
Valder Way
Charles Sturt University
Wagga Wagga NSW 2678
CREDIT CARD PAYMENT AUTHORITY
To:
Tel: +61 2 6933 4980
Email: [email protected]
www.csu.edu.au/online-shop
CSU Online Shop
Building 460
Valder Way
Charles Sturt University
Wagga Wagga NSW 2678
Name: ____________________________________________________________________
Address:____________________________________________________________________
_____________________________________________________________________________________________________
Mobile No/Email: ___________________________________________________________

Mastercard
Amount

Visacard
$
Expiry date
 / 
Card Number (all boxes must be completed)
   

Card Check Value (3 digits on back of card)
Card Holders Printed Name: _____________________________________________
Card Holders Signature: ________________________________________________