SPECIAL APPAREL ORDER FORM
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UNIVERSITY OF IOWA
SCHOOL AFFILIATION__________________________________________
IOWA CITY, IA
SCHOOL LOCATION - TOWN & STATE_________________________
MEASUREMENTS
(Please Give All Information Requested)
MALE
FEMALE
1. Height with shoes - top of head to floor_________ feet________ inches.
2. Chest size - without coat _________________inches.
3. Shirt sleeve measurement_________________inches.
(Measure from center-back of neck, over the top of the shoulder, and along the _ outer arm to the break at the back of the wrist.)
4. Cap size_______________________________inches.
5. Floor clearance desired___________________inches.
(We will provide a 8" clearance if you do not specify.)
6. Personalized initials (if desired; no extra charge) - specify: _____ _____ _____
Pricing below valid through June 30, 2014
Date needed_____________.
If request date is not possible:
Proceed - ship when ready
Call First
Please allow 6-8 weeks for manufacturing after the complete order is received in our Champaign Office.
DOCTORAL GOWN:
$449.80
607430
Special Doctoral Gown for University of Iowa
Gabardine Faculty Gown
$157.00
DOCTORAL HOOD: 064027
Doctoral Hood -Black Base Standard with Degree Velvet
DEGREE: ________________________________________
VELVET DEGREE/SUBJECT COLOR:___________________
SCHOOL: UNIVERSITY OF IOWA
DOCTORAL CAP: 112970/008854
8 SIDED Black Velvet Tam w/Gold Bullion Tassel
$136.10
ACCESSORIES:
GARMENT BAGS: HANGERS: E-Z Stor Garment Bag $10.40
Nylon Garment Bag $31.70
Carry-All Garment Bag $110.40
Black Contoured Hanger $2.55
Black Conformer 1 1/2" deep hanger $7.80
REMARKS & SPECIAL INSTRUCTIONS___________________________
_____________________________________________________________
_____________________________________________________________
COST SUMMARY OF ORDER
Gown................................................................................... $
Hood...................................................................................... Cap/Tam................................................................................ Tassel.................................................................................... Other Items: ___________ .................................................. ___________ .................................................. Cost of merchandise......................................................... _______________________________ ............................ SALES TAX - your local rate............................................. SHIPPING & HANDLING................................................ $
Ground Service (to U.S. 48) $19.95
2nd Day Air (to U.S. 48) $30.00
Next Day Air (to U.S. 48) $55.00
(Call if outside U.S. 48)
TOTAL COST OF ORDER.............................................. $
Less advance deposit enclosed........................................ (Please enclose 1/2 deposit if not using a credit card - see below)
BALANCE DUE ............................................................ $
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CREDIT CARD OR PURCHASE ORDER
VISA
Mastercard
Discover
Credit Card No._______________________________________________
Expiration Date_______________________________________________
Name on Card________________________________________________
Name exactly as it appears on card
Purchase Order #_____________________________________________
OFFICE USE ONLY:___________________________________________
FAX COMPLETED FORM TO 952-447-4449
To confirm your order, please contact our office at 952-447-4449
Sales
Customer’s
KEVIN MORTINSON
0513
Professional_______________________________No.___________
Signature________________________________ Date___________________________