Please provide the following contact information:

First Name
Last Name
Middle Initial
Billing Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please provide the following Personal Information:

Date of Birth
Sex	Male Female
Height
Weight

	SHIPPING ADDRESS (if different)
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Choose one of the following Shipping options:

Please Select One UPS Ground UPS 3 Day Air UPS 2 Day Air UPS 1 Day Air Saver (limited availability) UPS 1 Day Air UPS 1 Day Air Early A.M. (limited availability) Fedex Express (approx. 3 days) Fedex 2 Day Fedex Overnight Standard Fedex Overnight Express Other

Choose one of the following Stock Sizes:

None XXS (Kids) XS S M ML L XL XXL XXXL (Mens) Other Combination, Please call

Choose one of the following Body Color options:

Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Solid Arm Color options:

Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Collar Color options:

Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Arm Stripe Color options:

Add $25.00 (1 Item) or  $ 35.00 (2 Items)

None Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Side Stripe Color options:

Add $25.00 (1 Item) or  $ 35.00 (2 Items)

None Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Vcut Color options:

Add $25.00 (1 Item) or  $ 35.00 (2 Items)

None Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Outside Breast Panels Color options (Women Only):

None Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Center Breast Panel Color options (Women Only):

None Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Wrist Chevrons Color options:

Add $20.00 (1 Item) or  $ 30.00 (2 Items)

None Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Ankle Chevrons Color options:

Add $20.00 (1 Item) or  $ 30.00 (2 Items)

None Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Body of Hood Color options:

None Black Violet Sunnie KeyLime Royal Blue Other

Choose one of the following Center Hood Stripe Color options:

None Black Violet Sunnie KeyLime Royal Blue Other

Please describe any other type of color option here:

Select any of the following Accessory options that you are purchasing:

Cap ($19.99)                                       
Hood with Bib ($29.99)                  
Hood without Bib ($24.99)             
Pull-Over Vest   ($49.99)     
Pull-Over Hooded Vest ($64.99)   
Neoprene Cover   ($4.99 or free with Custom Fit Wetsuit)        
Pair of Neoprene Socks   ($19.99)  

Please use this space to specify:

	Color
	Material
	Thickness
	Any Other Information Needed

Choose one of the following Material options for your wetsuit:

Select One Nylon 2 Plush (7mm Only) Titex Plush Titex Smooth

Select any of the following Thickness options that apply:

1.5mm (Skin-In only)  
2.5mm (Nylon 2 only)  
3.0mm                                
5.0mm              
6.5mm                                                                                                                 

Select any of the following Add-On options that apply:

Wrist Seals	$ 18.50                                                    
Ankle Seals	$ 18.50                                                  
Neck Seal 	$ 10.00                                                       
Zipper Flap Seals	$10+                  
Wrist Zippers	$ 20.00                                                
Extra Long Wrist Zippers $ 27.50                         
Leg Zippers  $ 20.00                                                   
Extra Long Leg Zippers $ 27.50            
Relief Zipper $ 20.00 w/o cover & $ 27.50 w/cover                        
Side Zipper (FJ, Vest, Hooded Vests) $ 22.50  
Additional 1/2 Front Zipper  $ 18.50                   
Additional Full Front Zipper $ 25.00      
Additional 1/2 Back Zipper   $ 18.50                    
Additional Full Back Zipper  $ 25.00                  
Kevlar Knee Pads   $ 22.50                                        
Extra Large Kevlar Knee Pads   $ 35.00    
Kevlar Elbow Pads  $ 22.50                                        
Extra Large Kevlar Elbow Pads  $ 35.00                                                       

Select any of the following Pocket options that apply:

Key Pocket (Free w/custom orders)                                          
Flat Bicep Pocket   $ 20+                           
Expanding Bicep Pocket  $ 25+                  
Flat Thigh Pocket   $ 30+           
Expanding Thigh Pocket   $ 35+                  
Lower Flat Knife Pocket  $ 25+                
Upper Flat Knife Pocket  $ 15+               
Lower & Upper Flat Knife Pocket $ 35+
Other type of Pocket                                                                                     

Select any of the following Jacket Only Wetsuit Style options that apply:

Sleeveless Beavertail      
Short-Sleeve Beavertail  
Long-Sleeve Beavertail    
Sleeveless Frenchcut  
Short-Sleeve Frenchcut    
Long-Sleeve Frenchcut        
Sleeveless Shorty              
Short-Sleeve Shorty   
Long- Sleeve Shorty                                     

  

Would you like a Hood Attached?

Yes No

Choose one of the following Wetsuit Style options:

Please Select One One Piece Only One Piece & Sleeveless Stepin One Piece & Sleevless Beavertail One Piece & Sleeveless Frenchcut One Piece & Sleeveless Hooded Stepin One Piece & Sleeveless Hooded Beavertail One Piece & Sleeveless Hooded Frenchcut Farmer John Only Farmer John/Jane & Stepin Farmer John.Jane & Beavertail Farmer John/Jane & Frenchcut Farmer John/Jane & Waist Jacket Farmer John/Jane & Hooded Beavertail Farmer John/Jane & Hooded Waist Jacket Hooded Farmer John/Jane & Beavertail Hooded Farmer John/Jane & Frenchcut Hooded Farmer John/Jane & Stepin Other, Not Listed

Choose one of the following One Piece Zipper Placement options:

Please Select One Back Zipper Front Straight Zipper Front Slant Zipper

Choose one of the following Jacket Zipper Placement options:

Please Select One Back Zipper Front Straight Zipper Front Slant Zipper

If your wetsuit style is not listed above, please describe it here: