Name: Phone # Address: City: State: Select State ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING Zip: ______ E-mail Address: How Did You Hear About Us? Referred by: _______ Representative Name: NONE JACLYN LISA Wish List: Would you like a Brag Bag but want someone else to pay for it? If you would like for us to send your "Wish List" to your friends and family, this option is for you! Simply check the "Wish List" option under payment type, submit your completed order form, and we will send you more information. Bag Size: select one SMALL PURSE MEDIUM PURSE LARGE TOTE _______Bag Color: select one BLACK KHAKI Bag Type: (Please choose only one.) Brag Bag # of Face(s) select one 1 2 3 4 5 6 7 8 9 10 Teacher Bag (khaki bag only) Monogram (please type in full name): Monogram Thread Color select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black CHILD #1 Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) CHILD #2 (if needed) Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) CHILD #3 (if needed) Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) CHILD #4 (if needed) Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) CHILD #5 (if needed) Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) CHILD #6 (if needed) Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) CHILD #7 (if needed) Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) CHILD #8 (if needed) Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) CHILD #9 (if needed) Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) CHILD #10 (if needed) Child’s Name: Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____ Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat) SHIPPING: $5 flat rate for first item $2.50 each additional item shipped to the same address. Payment Type: Check___ PayPal___ Money Order/Cash Gift Certificate Gift Certificate Number Wish List Discount Coupon Code: (if applicable) Gift Options: (Please Check One) None Gift Certificate Gift tag included with bag **You can purchase a Gift Certificate or a Brag Bag as a gift, and we will send it for you! **If you choose this option, be sure to include the recipient's address and your message for the Gift tag in the Comments section. Comments: THANK YOU FOR YOUR ORDER You will receive an email confirmation and instructions for payment within 48 hours. _
Name: Phone #
Address:
City:
State: Select State ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING Zip: ______
E-mail Address:
How Did You Hear About Us?
Referred by: _______
Representative Name: NONE JACLYN LISA
Wish List: Would you like a Brag Bag but want someone else to pay for it? If you would like for us to send your "Wish List" to your friends and family, this option is for you! Simply check the "Wish List" option under payment type, submit your completed order form, and we will send you more information.
Bag Size: select one SMALL PURSE MEDIUM PURSE LARGE TOTE _______Bag Color: select one BLACK KHAKI
Bag Type: (Please choose only one.)
Brag Bag # of Face(s) select one 1 2 3 4 5 6 7 8 9 10
Teacher Bag (khaki bag only)
Monogram (please type in full name): Monogram Thread Color select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black
CHILD #1
Child’s Name:
Face Style Name: select one Madison Samantha Lindsey Sarah Baby Kathryn Lexi Caylan Ashton Reilly Kendall Francisco Clark Bryant Baby Alex Colby Abby Gracie Sophie Skin Color: select one peach light brown dark brown _____
Hair Color: select one blonde light brown dark brown red black ___Bow Color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black
Hat Color (Francisco only): trim select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black _fill select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black
Eye Color: select one blue green light brown dark brown ____Name color: select one baby blue royal blue navy blue red crimson orange yellow/gold lime green kelly green baby pink hot pink lavendar medium purple dark purple white black (we recommend using the same color as the bow or hat)
CHILD #2 (if needed)
CHILD #3 (if needed)
CHILD #4 (if needed)
CHILD #5 (if needed)
CHILD #6 (if needed)
CHILD #7 (if needed)
CHILD #8 (if needed)
CHILD #9 (if needed)
CHILD #10 (if needed)
SHIPPING: $5 flat rate for first item $2.50 each additional item shipped to the same address.
Payment Type: Check___ PayPal___ Money Order/Cash Gift Certificate Gift Certificate Number Wish List
Discount Coupon Code: (if applicable)
Gift Options: (Please Check One) None Gift Certificate Gift tag included with bag **You can purchase a Gift Certificate or a Brag Bag as a gift, and we will send it for you! **If you choose this option, be sure to include the recipient's address and your message for the Gift tag in the Comments section.
Comments:
_
home: bags: faces: referral rewards: order: contact © 2006 My Brag Bag
