Empire Dance Shop
School Leotard Order Form 2016
Level IV-VIII
131 S. Sherman
Spokane, WA 99202
P: 1-888-445-8848
Parent’s Name:_______________________________________________
F: 509-838-6929
Student’s Name: ______________________________________________
[email protected]
Shipping Address: ____________________________________________
___________________________________________________________
Telephone Number: ___________________________________________
Email Address: ________________________________________________
Name on Credit Card: ___________________________________________
Credit Card Number (Visa, MasterCard, Discover):
___________________________________________________________
Expiration Date: _________ CVV code:_________
Billing Address (if different):____________________________________
__________________________________________________________
Your local city tax rate and $8.00 shipping/handling charge is not included in the
leotard prices.
For use at Empire Dance Shop
If you would like to pay by check, please contact Empire Dance Shop for a total.
Date shipped:_________________
Payments by credit card will be charged at the time the order is shipped.
Tax %:__________
Class Level
Color/Fabric
Standard Style/Description
471 Turquoise Silkskyn
2533 Banded Pinch Front Cami
IV
470 Perfect Plum
Silkskyn
2518 Princess Seam Cami
V
VI
483 Royal Blue
Silkskyn
VII
485 Chocolate
Brown Silkskyn
VIII
486 Navy Blue Silkskyn
Men’s
481 White Silkskyn
Child $40.50
Child $43.00
Adult $44.50
Adult $47.00
2516 Pinch Front Cami
Child $39.50
Adult $43.50
2513 Shirred Empire Cami
Child $37.50
Adult $41.50
2521 Pinch Front/Low Back Cami
Child $41.00
Adult $45.00
Qty.
Date received:________________
Optional Style/Description
Qty.
Tax code:_________
Size
Total Qty.
Total $
2524 Center Seam Princess Cami
Child $43.50
Adult $47.50
2515 Plain Front Cami
Child $36.00
Adult $40.00
2201 Pinch Front Tank
Child $38.50
Adult $42.50
2643 Wide Strap Princess Tank
Child $39.00
Adult $43.00
2032 High X-Back Cami
Child $41.50
Adult $45.50
7207 Fitted Short Sleeve Shirt
Child $32.50
Adult $36.50
ORDERS ARE TO BE SUBMITTED DIRECTLY TO EMPIRE DANCE SHOP