Name:

Home Address:

City: State: Zip Code:

Phone Number Home: Phone Number Office:

I am part of the group.

will need this outfit on: .

Please deliver and pickup my outfit from the bell captain at the Hotel.

OR

I will pickup my outfit from your store.

I have rented from M. Stein before please use the measurement from the last order

Coat size is:

My Pants size is: inch waist with a inch INSEAM.

My Shirt size is: inch neck with a inch sleeve length.

My Shoe size is: if necessary.

If you know or want a specific style or have any other specific descriptions please enter here:

Your outfit must be paid for in advance by credit card!
You may fill this out or call 202.659.1434 with credit card number.

Credit card:

My Credit card number is: Expires:

Please type letters in the box as a security check

Store Hours: Monday - Friday 10:00AM until 6:00PM.
Saturday 10:00AM until 2:00PM.
You can print this out and fax it to us at 202.452.9362 or press submit to send to us.
We will call you to confirm we received you order.
Thank you for Choosing M. Stein & Co.

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