Order Form

Date: _________________________

If there are multiple shipping addresses, then please print out multiple copies of this form and
fill one out for each shirt being ordered.  If you are ordering more than one shirt but shipping
to the same address, then please indicate both colors and both sizes and write a note as to
which color goes with which size.  Thanks.

Name:________________________________________

Street Address: ________________________________

City: _______________________ State: ____________ Zip: ____________

Total # of shirts: _________________

Circle Color                                Circle Size
Pretty in Pink                                2T
Betty Blue                                     4T/5T
Ultra Violet                                    6
Right-on Red                                8
                                                 10/12

Notes:     ____________________________________________________________

           ____________________________________________________________


Shipping is $4.05 for 1 to 4 shirts, $6.05 for 5 to 8 shirts and $9.00 for 9 to 12 shirts, so please
include the shipping charges in your payment.  If you have any questions, then please email
customer support at karen@littlemisspink.com

Make Check or Money Order payable to Little Miss Pink.

Mail to :  Little Miss Pink
          Attn: Orders
          722 Great Plain Avenue
          Needham, MA  02492