Level 2 Uniform Order Form
 Please print this order form and return it with your payment to CCCC, PO Box 2518, 
Walnut Creek, CA 94595-0518. Credit Card orders may be faxed to 925-945-7578.

Student's Name _________________________________

Formal & Informal Uniform Pieces from CCCC
Payable to CCCC:

Black Satin Pants

Child Sizes: 4 6 8 10

 Qty ____ $22.00 Ea. Total__________

Child Sizes: 12 14 
Adult Sizes: 6 8 10 12 14

 Qty ____ $24.00 Ea. 

Total__________
Red sequin cummerbund
Waist Size _____________
Qty ____ $5.00 Ea.  Total__________

Red Logo T-Shirt
Child Sizes: M L 
Adult Sizes: S M L XL

Qty ____ $12.00 Ea. Total __________
TOTAL Payable to CCCC $__________

Method of Payment:

Cash Check Mastercard VISA
Credit Card Number _______________________
Exp. Date _______________________________
Name on Card ___________________________
 

Signature _______________________________

Note: 3% will be added to all credit card orders.

III. Other Uniform Requirements
You are also responsible for purchasing the following uniform pieces on your own:
Black socks or Opaque black nylons
Black dress shoes - closed toe, no platforms.