| Prom 2002 Order Form |
| Fax Order Only |
| Please print out this order form and fill in all necessary information. Fax this form to us at (407) 370-2846. |
| Bridal Arai, Inc. |
| Bay Hill Plaza, 7641 Turkey Lake Rd. |
| Orlando, FL 32819 |
| Tel (407)370-2989/Fax (407) 370-2846 |
| Customer Information: | Prom Date: / / |
| Name of High School: | |
| Name: | |
| Address: | |
| Phone/(Day Time): | Fax: |
| Email: | |
| Credit Card: Visa, Master Card and Amex Accepted | Exp. Date: / / |
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| *We require 50% Deposit of purchase price to place your order. Please read below and sign. |
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| I hereby acknowledge that Bridal Arai, Inc. is under no obligation to refund my payment of $____________. Such payment represents fifty percent (50%) of the purchase price of formal apparel purchased from Bridal Arai, Inc. The remaining balance including sales tax will be paid in full to Bridal Arai, Inc. at the time of the (formal apparel) pick up. We have good availability on all attire. However, in the event that your order is not available, we will refund one hundred percent (100%) of your deposit. |
| Signature | Date / / |
| Print Name |