PRE-PAID CLASS UNIFORM ORDER RETURN PRE-PAID ORDERS TO YOUR TEACHER PLEASE ALLOW 1 TO 2 WEEKS FOR DELIVERY Name: _____________________ Class:__________ Ph: ____________ Date: ________ Please circle: color size and price quantity Leotard & Skirt (set): Pink Blue S- M- L- _____ Leotard (only): Pink Blue Black S- M- L- _____ Skirt (only): Pink Blue S- M- L- _____ Black M- L- _____ Black short and T- shirt (set): S- M- L- _____ Jazz Pants: Child size S- M- L- _____ Adult size S- M- L- _____ Jazz Shorts: Child size S- M- L- _____ Adult size S- M- L- _____ DMA Logo Shirt Children size S- M- L- _____ Adult size S- M- L- _____ GYMNASTICS LEO AVAILABLE - contact DiRodin@hawaii.rr.com TOTAL: _______ (If paying by check, please make payable to Di Rodin) Sorry, we do not carry dance shoes. Dance shoes are available at Step-N-Up, Payless, Wal-Mart and other retail stores. AMT: $_______ BY CHECK/CASH DATE: / / TEACHER'S INITIALS______ PARENT RECEIVED UNIFORM ON: / / PARENT'S INITIALS _______ WWW.DMA-KBG.COM DI RODIN- Director Tel.: 479-3273 DiRodin@hawaii.rr.com