STENCIL AND EMBROIDERY FORM
UNIFORM
NAMES
Proprintwear
and Stencil-Pro respectfully requests that you carefully check your order for spelling mistakes. We
shall print and/or stitch exactly what you have submitted. Please
fill out this
form and ship it with your garments to:
First Name:
AL (Alabama)
AK (Alaska)
AZ (Arizona)
AR (Arkansas)
CA (California)
CO (Colorado)
CT (Connecticut)
DE (Delaware)
DC (District of Columbia)
FL (Florida)
GA (Georgia)
HI (Hawaii)
ID (Idaho)
IL (Illinois)
IN (Indiana)
IA (Iowa)
KS (Kansas)
KY (Kentucky)
LA (Louisiana)
ME (Maine)
MD (Maryland)
MA (Massachusetts)
MI (Michigan)
MN (Minnesota)
MS (Mississippi)
MO (Missouri)
MT (Montana)
NE (Nebraska)
NV (Nevada)
NH (New Hampshire)
NJ (New Jersey)
NM (New Mexico)
NY (New York)
NC (North Carolina)
ND (North Dakota)
OH (Ohio)
OK (Oklahoma)
OR (Oregon)
PA (Pennsylvania)
RI (Rhode Island)
SC (South Carolina)
SD (South Dakota)
TN (Tennessee)
TX (Texas)
UT (Utah)
VT (Vermont)
VA (Virginia)
WA (Washington)
WV (West Virginia)
WI (Wisconsin)
WY (Wyoming)
SHIPPING Shall be
shipped to the above address unless specified below.
First Name:
Address:
AL (Alabama)
AK (Alaska)
AZ (Arizona)
AR (Arkansas)
CA (California)
CO (Colorado)
CT (Connecticut)
DE (Delaware)
DC (District of Columbia)
FL (Florida)
GA (Georgia)
HI (Hawaii)
ID (Idaho)
IL (Illinois)
IN (Indiana)
IA (Iowa)
KS (Kansas)
KY (Kentucky)
LA (Louisiana)
ME (Maine)
MD (Maryland)
MA (Massachusetts)
MI (Michigan)
MN (Minnesota)
MS (Mississippi)
MO (Missouri)
MT (Montana)
NE (Nebraska)
NV (Nevada)
NH (New Hampshire)
NJ (New Jersey)
NM (New Mexico)
NY (New York)
NC (North Carolina)
ND (North Dakota)
OH (Ohio)
OK (Oklahoma)
OR (Oregon)
PA (Pennsylvania)
RI (Rhode Island)
SC (South Carolina)
SD (South Dakota)
TN (Tennessee)
TX (Texas)
UT (Utah)
VT (Vermont)
VA (Virginia)
WA (Washington)
WV (West Virginia)
WI (Wisconsin)
WY (Wyoming)
STENCILED NAMES If you wish to
have your first name initial printed please list it here (as size permits).
Initial * (optional)
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"USA"
print shall be an option on all Jackets and Lames.
Jackets
0
1 - $38 Name & USA (Print Fee $25 + USPS Priority Mail ship W/Insurance $13)
2 - $66 Name & USA (Print Fees $50 + $16 shipping
& handling)
3 - $95 Name & USA (Print Fee $75 + USPS Priority Mail ship W/Insurance $20)
4 - $124 Name & USA (Print Fee $100 + USPS Priority Mail ship W/Insurance $24)
1 - $33 Name (Print Fee $20 + USPS Priority Mail ship W/Insurance $16)
2 - $56 Name (Print Fee $40 + USPS Priority Mail ship W/Insurance $12)
3 - $80 Name (Print Fee $60 + USPS Priority Mail ship W/Insurance $20)
4 - $104 Name (Print Fee $80 + USPS Priority Mail ship W/Insurance $24)
Lames
0
1 - $38 Name & USA (Print Fee $25 + USPS Priority Mail ship W/Insurance $13)
2 - $66.00 Name & USA (Print Fees $50.00 + $16.00 shipping
& handling)
3 - $95 Name & USA (Print Fee $75 + USPS Priority Mail ship W/Insurance $20)
4 - $124 Name & USA (Print Fee $100 + USPS Priority Mail ship W/Insurance $24)
1 - $33 Name (Print Fee $20 + USPS Priority Mail ship W/Insurance $16)
2 - $56 Name (Print Fee $40 + USPS Priority Mail ship W/Insurance $12)
3 - $80 Name (Print Fee $60 + USPS Priority Mail ship W/Insurance $20)
4 - $104 Name (Print Fee $80 + USPS Priority Mail ship W/Insurance $24)
"USA" print
shall be an option on all pants (as size permits).
Pants (Left Handed)
0
1 - $38 Name & USA (Print Fee $25 + USPS Priority Mail ship W/Insurance $13)
2 - $66 Name & USA (Print Fees $50 + $16 shipping
& handling)
3 - $95 Name & USA (Print Fee $75 + USPS Priority Mail ship W/Insurance $20)
4 - $124 Name & USA (Print Fee $100 + USPS Priority Mail ship W/Insurance $24)
1 - $33 Name (Print Fee $20 + USPS Priority Mail ship W/Insurance $16)
2 - $56 Name (Print Fee $40 + USPS Priority Mail ship W/Insurance $12)
3 - $80 Name (Print Fee $60 + USPS Priority Mail ship W/Insurance $20)
4 - $104 Name (Print Fee $80 + USPS Priority Mail ship W/Insurance $24)
Pants (Right Handed)
0
1 - $38 Name & USA (Print Fee $25 + USPS Priority Mail ship W/Insurance $13)
2 - $66 Name & USA (Print Fees $50 + $16 shipping
& handling)
3 - $95 Name & USA (Print Fee $75 + USPS Priority Mail ship W/Insurance $20)
4 - $124 Name & USA (Print Fee $100 + USPS Priority Mail ship W/Insurance $24)
1 - $33 Name (Print Fee $20 + USPS Priority Mail ship W/Insurance $16)
2 - $56 Name (Print Fee $40 + USPS Priority Mail ship W/Insurance $12)
3 - $80 Name (Print Fee $60 + USPS Priority Mail ship W/Insurance $20)
4 - $104 Name (Print Fee $80 + USPS Priority Mail ship W/Insurance $24)
EMBROIDERED NAMES If you wish to
have your first name initial embroidered please list it here (as size permits).
Initial * (optional)
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Epee Jackets
2 Letters & USA $75 (Embroidery Fee $60 + USPS Priority Mail W/Insurance $15.00)
3 Letters & USA $85 (Embroidery Fee $70 + USPS Priority Mail W/Insurance $15.00)
4 Letters & USA $92 (Embroidery Fee $77 + USPS Priority Mail W/Insurance $15.00)
5 Letters & USA $101 (Embroidery Fee $84 + USPS Priority Mail W/Insurance $15.00)
6 Letters & USA $101 (Embroidery Fee $84 + USPS Priority Mail W/Insurance $15.00)
7 Letters & USA $101 (Embroidery Fee $84 + USPS Priority Mail W/Insurance $15.00)
8 Letters & USA $101 (Embroidery Fee $84 + USPS Priority Mail W/Insurance $15.00)
9 Letters & USA $101 (Embroidery Fee $84 + USPS Priority Mail W/Insurance $15.00)
10 Letters & USA $101 (Embroidery Fee $84 + USPS Priority Mail W/Insurance $15.00)
Total Due: $
Credit Card
N/A
Visa
Master Card
American Express
Discover
Credit Card Number
CVV2 Number (3 digit number on
back of card)
We also accept Personal Checks and Money Orders made payable to Proprintwea r.
I accept the terms and conditions set forth by Proprintwear and Stencil-Pro. I agree to maximum compensation as determined by the fair market value of any disputed article of clothing. If you require over night delivery service please contact us prior to shipping your items to determine availability.
Signature: ____________________________________
Please email us a copy of this form in addition to mailing it with your package. This will allow us to look for your package and expedite the embellishment phase and eliminate unnecessary delays ensuring prompt service.
PROPRINTWEAR
Telephone Fax
Email Custom Orderscustom@proprintwear.com
Customer Servicecustomercare@proprintwear.com
