Garter Mum Order Form Cistercian Homecoming Game: September 21, 2012 Enter C if ordering only Cistercian, J for only Jesuit, or JC if ordering for both homecomings Please, leave other boxes blank Jesuit Homecoming Game: November 2, 2012 One form per student please Student’s Name ___________________________________________ Student ID# ___________ Email ________________________________________________ Cell Phone We will text you when your order is ready for pick-up at St. Ursula. Jesuit mums will be ready for pick up in mid October. Date’s first name: _________________________________________ Capital letters please Date’s first name: _________________________________________ Capital letters please Homecoming: ________________________ Grade: Fr Soph Jr. Sr. Homecoming: ________________________ Grade: Fr Soph Jr. Sr. Garter mum quantity________ at $45.00 each Total: ___________ Girl name quantity ________ at $ 2.50 each Total: ___________ Boy name quantity ________ at $ 2.50 each Total: ___________ Invoice Total: All charges will be applied to the student’s Bear Necessities Account Non Ursuline Academy students, please pay by cash or check payable to UA Mothers’ Club Check #: __________________________ All mums are handmade and may vary slightly For more information please call Martha at 214-244-0198 or e-mail us at mummoms@gmail.com Bear Necessities check to process order Bottom portion to process order and to be detached by Mum Moms Mum order # Student’s Name _______________________________________________ Student ID# Cell Phone Date’s first name: _________________________________________ Capital letters please Date’s first name: _________________________________________ Capital letters please Homecoming: ________________________ Grade: Fr Soph Jr. Sr. Homecoming: ________________________ Grade: Fr Soph Jr. Sr.