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222 Papalaua Street Suite 221 ~ Lahaina, Maui, Hawaii 96761 Phone: (808) 667-5822 ~ Fax: (808) 667-5811 ~ Toll Free: (800) 886-5313 Group Name:__________________________________________Event Date:_______________________ Your Name:__________________________________Referred by:_____________________________ Residence:____________________________________________________________________________ Home Phone:_______________________Work:________________________Fax:___________________ Hotel:_______________________________Arrival date:_______________Ck/out Date:_______________ Note: Go to
your nearest Bridal Shop to get proper measurement(s). The better the measurement(s),
the better your gown/dress will fit. We can not be held responsible for measurements
not performed in our salon and we will try our best to correct any improper
measurements taken from outside sources.
Catalog Name:___________________________
Dress Style#:____________________________Dress
Color:_____________________Dress
Size:_______
DRESS SHAPE
MEASUREMENTS:
Nape:__________Bust:__________Waist:__________Hips:__________UDM:__________H/H:__________
Body Height:______________Body Weight:_______________
Shoe Height:_____________
All special orders must be received 6
months prior to wear date.
Once you have placed your order,
there is a 24 hours cancellation period. Your down payment will be forfeited if order is cancelled after 24 hours. A valid credit card
number will expedite your order. Customer Credit Card#_________________________________________Exp.
Date:____________________CCV:______
Type:________________Name On Card:____________________________________________________________
C/C Billing address:___________________________________________________________________________________
Signature:__________________________________________________________________________________________
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