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                  Collegiate Order No.
Collegiate Apparel
®
Another quality product of Herff Jones, Inc.
            Customer No.                                Customer No.
SCHOOL AFFILIATION _________________________________________  SCHOOL LOCATION - TOWN & STATE ________________________  
 
  Sales  Customer’s
  Professional ______________________________ No. ___________ Signature _______________________________ Date   __________________________  
SPECIAL APPAREL ORDER FORM
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DOCTORAL HOOD:  
   
           Doctoral Hood -Black Base Standard with Degree Velvet
             DEGREE/SUBJECT: _________________________________
  VELVET DEGREE/SUBJECT COLOR: __________________
             SCHOOL: UNIVERSITY OF LOUISVILLE
Individual
Street Address 
City                                                           State                            Zip
Daytime Phone                                                       Best Time To Call
Email address
(            )
Individual
Street Address 
City                                   County                            State            Zip
Office Phone                                                       Best Time To Call
Email address
DOCTORAL GOWN: 
            Special Doctoral Faculty Gown for University of Louisville
  Gabardine Faculty Gown
UNIVERSITY OF LOUISVILLE
LOUISVILLE, KY
$418.60
DOCTORAL CAP:  
 
           8 SIDED Black Velvet Tam w/Gold Bullion Tassel
$152.00
$131.40
PATRICK CAVAZOS                        1153
Pricing below valid through June 30, 2012
Date needed_____________.  
If request date is not possible:    Proceed - ship when ready    Call First
FAX COMPLETED FORM TO 317-578-8140
ACCESSORIES:
  REMARKS & SPECIAL INSTRUCTIONS  __________________________
_____________________________________________________________
_____________________________________________________________  
MEASUREMENTS
(Please Give All Information Requested)
 MALE                 FEMALE
 1.  Height with shoes - top of head to floor ________ feet _______ inches.
 2.  Chest size - without coat  _________________ inches.
 3.  Shirt sleeve measurement ________________ inches.
  (Measure from center-back of neck, over the top of the shoulder, and along the    
  outer arm to the break at the back of the wrist.)
 4.  Cap size ______________________________inches.
 5.  Floor clearance desired __________________ inches.
  (We will provide a 8" clearance if you do not specify.)
 6.   Personalized initials (if desired; no extra charge) - specify: _____ _____ _____
COST SUMMARY OF ORDER
Gown .................................................................................. $  __________
Hood .....................................................................................   __________ 
Cap/Tam ...............................................................................    __________
Tassel ...................................................................................   __________
Other Items:   __________   .................................................    __________
   __________   .................................................    __________
  Cost of merchandise.........................................................   __________
   ______________________________   ...........................   __________
  SALES TAX - your local rate .............................................    __________
  SHIPPING & HANDLING ............................................... $  __________
     Ground Service (to U.S. 48) $19.95
     2nd Day Air (to U.S. 48) $30.00
     Next Day Air (to U.S. 48) $55.00
   (Call if outside U.S. 48)
  TOTAL COST OF ORDER ..............................................$  __________ 
  Less advance deposit enclosed .......................................   __________
  (Please enclose 1/2 deposit if not using a credit card - see below)
  BALANCE DUE   ...........................................................$  __________
CREDIT CARD OR PURCHASE ORDER
  VISA       Mastercard       Discover
Credit Card No. ______________________________________________
Expiration Date ______________________________________________
Name on Card _______________________________________________
Name exactly as it appears on card
Purchase Order # ____________________________________________
OFFICE USE ONLY: __________________________________________
GARMENT BAGS:      E-Z Stor Garment Bag $10.00 
     Nylon Garment Bag $30.60 
     Carry-All Garment Bag $106.60 
HANGERS:       Black Contoured Hanger $2.35 
      Black Conformer 1 1/2" deep hanger $7.50