Alternative Shopping & Gift Baskets
FILL OUT AND SUBMIT THE FORM BELOW

PERSONAL OR GIFT INFORMATION


Tell Us What You Are Looking For:
Gift Wrap?: Male?: Female?:
Specify occasion?
Please Specify Other Occasion :
Please Specify Preferred Designer:
Please Specify Preferred Colors :
Please Fill In
Clothing Sizes :		 Tops:Shirt:
Shoes:Jacket:
Bottoms:Suit Size:
Other Sizes:
Clothing Requests
We Need 
Figure Type
What Type of Clothing
Do You Need
Request Spending Limit: Spending Amount?
Special Instructions - Please explain below
Gift is being sent to:
Name
Company
Address
Phone #
Message On Card:
Special Concerns, Special Delivery Instructions, Clothes Sizes, Comments, Personalization Information, Type of Gift, etc.?

PAYMENT INFORMATION


Credit Card:
Credit Card Number:
Expiration Date:
Month: 
  Year: 
Name of Cardholder:
Cardholder's Phone:
For Credit Card Verification
House Number:ZIP Code:
NOTE: Please fill this in if different then mailing address.

YOUR MAILING NAME AND ADDRESS


Email Address:
We need your E-mail Address to confirm your order!
How You Found Us:
Please Help Us By Answering This!
Salutation:
First Name:
Last Name:
Address:
City:
State/Province:
 Postal (ZIP) Code:
Please double check your information for accuracy before submitting it.

By submitting your Credit Card information , you give Alternative Shopping & Gift Baskets permission to electronically charge your Credit Card for this purchase & our fees.
 
 

Your credit card also provides you with important consumer protections that safeguard your purchases.

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