Customers using money orders to purchase a prom dress must print this page, fill out the information and mail it with their money order. Before mailing this form, call us at 1 877-900-7766 for a final price quote and stock availability.

Please mail all money orders to...

PLEASE SEND THE MONEY ORDER BY CERTIFIED MAIL FOR YOUR OWN PROTECTION

Promgirl

4700 Wissahickon Avenue, Building K, Box 100

Philadelphia PA 19144

Order by mail:

NAME: ________________________________________________

ADDRESS: _____________________________________________

CITY: ____________STATE: ________ ZIP: ________________

PHONE NUMBER: ________________________________________

EVENT DATE: _________________________________________

DRESS STYLE: ________________________________________

SIZE : __________________COLOR : ____________________

MEASUREMENTS: BUST: _____WAIST: _______ HIPS: __________

PLEASE SEND THE MONEY ORDER BY CERTIFIED MAIL FOR YOUR OWN PROTECTION