Student Information Name:
School:
Teacher/Room:
Phone:
Credit Card Information: Name on card: _____________________________ Phone: ____________ Card #: ___________________________________ Expiration: ________
Packages:
PRICE
Circle below : MasterCard or Visa
QUANTITY
TOTAL
GOLD PACKAGE $
30.00
$
25.00
$
20.00
$
15.00
Additional Outfit
$
10.00
School T-shirt (for animal)
$
6.00
Boots
$
7.00
Shoes or Sandals
$
6.00
Hat
$
5.00
Sunglasses, Bandana or Jewelry
$
4.00
Choice of Animal & an Outfit, a "School" Animal T-shirt, Birth Certificate, Wishing Star & Carrier Box
SILVER PACKAGE Choice of any Animal & any Outfit, Birth Certificate, Wishing Star & Carrier Box
BRONZE PACKAGE Choice of any Animal, & a "School" T-shirt for the Animal, Birth Certificate, Wishing Star & Carrier Box
BASIC PACKAGE Choice of any Animal, Birth Certificate & Wishing Star
Extra Accessories:
Make checks payable to your group.
GRAND TOTAL
All Animals, Outfits and Accessories are selected AT the event and are subject to availability.
Moyer Marketing, Inc. 1-800-51-MOYER www.moyermarketing.com