Chipping Norton Public School

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Chipping Norton Public School

2017 UNIFORM SHOP ORDER FORM

Student Name: ______Class:______
Parent Name: ______Mobile:______
Summer Uniform / 4 / 6 / 8 / 10 / 12 / 14 / 16 / Qty / Price / TOTAL $
Girls Summer Dress / $38.00 / $
Lemon Polo Shirt - Boys & Girls / $22.00 / $
Boys Grey Shorts / $18.00 / $
Girls Green Shorts / $20.00 / $
White Short Socks - Girls / 9-12 o 13-3 o 3-8 o / $ 4.00 / $
Grey Short Socks - Boys / 9-12 o 13-3 o 3-8 o / $ 4.00 / $
Sports Summer Uniform / 4 / 6 / 8 / 10 / 12 / 14 / 16 / Qty / Price / TOTAL $
Sports Shorts - Boys & Girls / $22.00 / $
Sports Shirt - Boys & Girls / $25.00 / $
House T-Shirt colour:______/ $6.00 / $
Sports Socks (PSSA Sport Only) / $15.00 / $
Winter Uniform / 4 / 6 / 8 / 10 / 12 / 14 / 16 / Qty / Price / TOTAL $
Fleecy Zip Jacket - Boys & Girls / $30.00 / $
Long Sleeve Polo - Boys & Girls / $25.00 / $
Boys Grey Long Pants / $20.00 / $
Girls Green Long Pants / $22.00 / $
Girls Winter Tunic / $42.00 / $
Stockings – Bottle Green / 3-5 o 6-9 o 10-12 o M o / $6.00 / $
Gloves / One Size Fits All / $5.00 / $
Scarf / One Size Fits All / $6.00 / $
Sports Winter Uniform / 4 / 6 / 8 / 10 / 12 / 14 / 16 / Qty / Price / TOTAL $
Microfibre Jacket / $35.00 / $
Microfibre Track Pants / $25.00 / $
Extras / Qty / Price / TOTAL $
Bag Pack: Back Pack, Library Bag, Canteen Bag & Excursion Bag / $65.00 / $
School Back Pack / $40.00 / $
School Excursion Bag / $10.00 / $
School Library Bag / $15.00 / $
School Hat / S o M o L o / $15.00 / $
School Cap / $15.00 / $
Note Tote / $15.00 / $
Canteen Lunch Bag / $10.00 / $
Scrunchie x 2 / $5.00 / $
* All Prices are subject to change without notice updated 23/05/16 / Total Amount / $

Payment Type: Cash o Cheque o EFTPOS - Visa o MasterCard o

Card Holder Full Name: ______

Card Number: c c c c - c c c c - c c c c - c c c c

CCV Number (3 digit on back of card): ______Expiry Date: ______

Card Holders Signature:______