Orchestra Jacket Order Form

Student’s Name:

 

 

Grade:

 

 

Parent’s Name

 

 

Phone Number:

 

Check If Gift:

 

 

 

**Purple nylon Charles River jacket with hood sweatshirt lining

**lettering in gold

Design choice (on left chest):

 

 

 

____violin/viola

____cello/bass

 

____lyre w/wreath

 

Size

Quantity

 

Cost

 

Total

 

 

Small

 

 

$60.00

 

$

 

 

 

Medium

 

 

$60.00

 

$

 

 

 

Large

 

 

$60.00

 

$

 

 

 

X Large

 

 

$60.00

 

$

 

 

 

XX Large

 

 

$65.00

 

$

 

 

 

XXX Large

 

 

$70.00

 

$

 

 

 

 

 

 

 

 

 

 

Single Name On Pocket

$5.00

 

$

 

 

 

Name:

 

 

 

 

 

 

First & Last Name on Pocket

$10.00

 

$

 

 

 

Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Grand Total

 

$

 

 

 

**Checks and/or Money Orders Made Payable To B.A.S.S.

**No Cash Please**