Full Name:
Wedding Date:
Email Address
Phone Number:
Address:
City and State:
Number of tickets
requested
Payment
We accept Cash, Check, Money Order, or all Major Credit Cards.
Payment Amount
Credit Card
Billing Address
Same as Above
Different
I hereby authorize Bridal Boutique & Tux Shoppe to charge the amount checked above to
my charge card.  I understand that should the wedding be cancelled, I am still obligated
to accept the merchandise ordered for me and agree to do so.
I understand and agree to the policy of this store as written in this document.
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