Request an Appointment

Personal Information

*Name:

Telephone:

*E-mail:

Appointments Requested

Primary Date/Time:

/

Secondary Date/Time:

/

Tertiary Date/Time:

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Event Information

Event Type:

Event Date:

Items Needed (list with name of customer):

Measurements*

Name

Bust

Waist

Hips


Security

*Human-Readable Code:


Please type the code seen above in the box below.

*Please note that the sizes that you provide on this form will be the approximate size. You will need to come in for a fitting to get the exact size required.