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Siobhan Wear Fax Order Form
Please print out this form, then fill in your details an fax it to us, thank you for your custom
Siobhan Wear House
#13 Connolly Street,
Bandon,
Co. Cork,
Ireland.

From Ireland Tel : 023-8843993 or 021-4378255
From Ireland FAX : 023 - 54040

From outside Ireland Tel: +353-23-8843993 or  +353-21-4378255
From outside Ireland Fax: +353 - 23 - 8854040

Item name: ________________________________________________
Item number: ________________________________________________
Fabric:    ________________________________________________
Fabric colour:  ________________________________________________
Lining: ________________________________________________
Lining Colour: ________________________________________________
Height: Dress Size (I): ______________Bust Size (E): ______________ (women only)
Full Height (J) : ________________________
Desire finished
length of garment
in inches
or centemetres (H) :
________________________
Desire finished
length of sleeve
in inches
or centemetres (K) :
________________________
Chest Size (F): ________________________(men only)
Shoulder Size (G): ________________________(from tip of one shoulder to tip of other across the back)
Neck
Curcumference (B):
________________________  
Neck
to Shoulder (C):
________________________  
Shoulder to Wrist (D): ________________________  
Length required: ________________________(knee? / calf? / ankle? / toe?)
 Comments/changes:   _____________________________________________________________________
 Quantity: _________  Unit price :_________  Shipping:________  Insurance:_________ Total:____________

Other Comments:

Cheque  Money Order  Master Card  Visa  Access
Total $:          _______________________
Expiry Date : _______________________ 
Card Number:

Signature______________________________________
Credit Card Billing details: Delivery details: (if different from billing details) 
Name _______________________________ Name _______________________________
Street _______________________________ Street _______________________________
City/State/Zip _______________________________ City/State/Zip _______________________________
Phone # _______________________________ Phone # _______________________________
Email address _______________________________ Email address _______________________________