Level 3 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 |
|
Qty ____ $22.00 Ea. | Total__________ |
|
Qty ____ $24.00 Ea. |
Total__________ |
Red sequin cummerbund |
Qty ____ $5.00 Ea. | Total__________ |
|
Qty ____ $12.00 Ea. | Total __________ |
Red Embroidered Logo Polo |
Qty ____ $25.00 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.
