Retail Order Form
    (Use the PRINT function on your browser to print the order page)


                         Renaissance  Dancewear
                              P.O. Box 3884
                        Glendale, CA 91221-0884 USA


                             818-845-5005 phone
                             818-845-5858 fax
                E-Mail: ajs@RenaissanceDancewear.com



STYLE  QUANTITY    DESCRIPTION     FABRIC  COLOR*   SIZE   PRICE EACH  TOTAL
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                                                            Subtotal |
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                               Tax (7.75% CA, 8.25% Los Angeles Co.) |
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    Shipping, ($5.00 for first item, $2.00 for each subsequent item) |
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                                                               TOTAL |
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Name_________________________________________________________________


Company or Organization______________________________________________


Street Address_______________________________________________________


City__________________________________ State________ Zip_____________


Day Phone________________________ Deadline?__________________________



First Time Customers: Where did you hear about us?___________________


Credit Card # __________________________________  Exp. Date _________


Name as it appears on the card ___________________________________


Signature ________________________________________________



           Subtotal_______________


           Tax 5%_________________
               (IN residents only)

           Custom Dye Charges* _________


           Shipping_______________


           TOTAL DUE______________


           PAID___________________


           BAL/REF DUE_______________