| Name: | |
| Address: | |
| Phone number: | |
| Items Enclosed | |
| Gown | Veil |
| Gloves | Shoes |
| Hat | Garter |
| List any other keepsakes enclosed:
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| List any special repairs or spotting needs:
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| Gown value: (Gown value must be filled in or liability will be limited to $500) |
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| Ship UPS to: CHERISHED HEIRLOOMING Westwoods Technology Centre 121 Westwoods Drive Chapin, SC 29036 1-800-343-4242 |
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