Made4Me Order Form Customer Information Name: ____________________________________________________ Date: ___________________ Address: __________________________________________________________________________ Email: ________________________________ Telephone     Home: _________________ Cell Phone: _________________ Office: ________________ Current Bra Size: __________   Age: _________ Measurememts While wearing your most supportive bra Over Bust: ______ Bust Line: ______ Under Bust: ______ Length of Right Bust: ______ Width of Right Bust: ______ Length of Left Bust: ______ Width of Left Bust: ______ Without a bra Over Bust: ______ Bust Line: ______ Under Bust: ______ Length of Right Bust: ______ Width of Right Bust: ______ Length of Left Bust: ______ Width of Left Bust: ______ Order Information Bra Style:_______________________ (we recommend ComfortaBra if this is your first order) Bra Price:__________ Quantity:_____ Bra Total:__________ Pattern Generation Fee:__________ Shipping/Handling Charge:__________ 6.5% Tax for Florida Resident:__________ Grand Total:__________ Send a check or money order (payable to Made4Me Inc.) together with this form to: Made4Me Inc. 1714 Rachel's Ridge Loop Ocoee, FL 34761