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Stop Music

Fandango Order Payment Form
NOTES:
  • Items I, J, & K, may only be purchased in addition to any package.
  • Group packages must be paid for at the dance.
  • Packages must be submitted by 12PM of the day before the dance.
    		•
    Student Name
    Address
    City, State, ZIP
    		 ,
    Phone
    Email
    School
    Dress Color
    Order Information
    Item Price Quantity Total
    Package A $20.00
    Package B $30.00
    Package C $40.00
    Package D $50.00
    Package E $70.00
    Package F $90.00
    Package H $65.00
    I - 1 10x13 Print $25.00
    J - 1 8x10 Print $10.00
    K - 2 5x7 Prints $10.00
    L - 8 Wallets $10.00
    Order Total:
    Payment Information
    Credit Card Type
    Credit Card Number
    Cardholder Name
    Card Expiration Date
    		 /
    CVV
    (Card Verification Value:
    The last 3 digits on the back of
    your card in the signature panel)



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