Basia
Custom Design
22215 131 AVE SE
Kent, WA 98031
Tel: 206-434-6106
ORDER FORM
1. Name________________________
2. Adres________________________
_______________________________
3. Tel:__________________________
4. Description
of costume:_____________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
5. Quantity___________________________________________
6. Estimated
cost_______________________________________
7. Desired delivery
date________________________________________
8. Downpayment______________________________________
9.Comments/details____________________________________
_____________________________________________________
_____________________________________________________
Customer signature
Date: