Customer Account Information Order Form please fax: 214.522.7756 or email: creatvAssc@aol.com questions please call 214.526.3128

Date: _______ Contact Name: ___________________________________ Business Name: ____________________________________ Address: __________________________________ City: _____________________________________ State: ______ Zip Code: ___________ Phone Number: __________________________ Email Address: ____________________________________ URL: __________________________ Shipping Address (if different from above) Contact Name: ________________________________________________ Business Name: ____________________________________ Address: __________________________________ City: _____________________________________ State: ______ Zip Code: ___________ Payment Information MC: ____ Visa: ____ Credit Card Number: ___________________________________________ Exp: _______ Security Code: ________ Credit Card Holders Address (if different from shipping) Contact Name: ________________________________________________ Business Name: ____________________________________ Address: __________________________________ City: _____________________________________ State: ______ Zip Code: ___________ if customer address is in Texas, please include Tax ID # Tax ID: ________________________________________

DESIGNER SHOWER CAPS

101. Wedding Night 102. Baby Girl 106. Snow Balls 108. Corsage 113. Wedding Cake 115. Flower Girl 303. Rose Sparkle #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 304. Fire Works 305. Gin & Tonic 403. Sky 412. Rivera 416. Pinky Ring 418. Flip Flop 424. Red Hot #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 502. Madison Ave 503. Milk Shake 505. Starry Night 507. Lollypops 510. Sun Burst 512. Plum Pudding 513. Singing In The... #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 514. Lime Jello 515. Morning Hang... 516. Take Me Out... 518. Dominos 520. Purple Haze 525. Blue Birds 526. Blue Moon #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 528. Very Berry 529. Lime Sparkles 532. Lime & Hot... 536. Raspberries 537. Black Tie 551. Sparkle Sky 552. Taffy #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 553. Dancing The... 611. Route 66 613. Summer Vaca... 629. Happiness 704. Strawberry... 706. 4th of July 720. Park Ave #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 724. Pink Bells 728. Pale Pink Bells 729. Blue Bells 730. Day Dreams 731. Summer Days 732. Paradise Island 737. Marilyn #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 738. Mauve Bells 739. Sky Breeze 740. Cherry Licorice 741. Black Licorice 744. Green Zig Zag 746. Pink & Blue Zig 752. Zebra Stripes #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 754. Vanity Fair 801. Lady Bugs 802. Wildcat 803. Bumble Bees 804. Lipstick 806. Cheerleaders 807. Butterflies #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 810. Sea Shells 811. Midnight Lace 813. Black Lace 814. Pearls 815. Jewels 816. Mac kenzie... 819. Cheeta #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 820. Squiggles 821. French Maid 824. Harliquin 825. Flower Garden 826. Jungle Leaves 835. Paillets 843. Water lily #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 845. Night Sparkles 846. Lace Polka 851. Butterflies Are. 852. Pink Cloud 853. My Fair Lady 854. Aqua Sparkles 856. Cherry Daiquiri #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 857. Blue Daiquiri 860. Dragon Flies 895. All Over Black... 902. Sunrise 906. Summer Fun 910. Yellow Flower. 1002. Sunshine #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________   1003. Flamingos 1006. Peachy Clean 1008. Hot Stuff 1010. Spicy 1011. One perfect ... 1016. Gerber Daisy 1017. -Washington... #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 1022. Sweet... 1023. Butterfingers 1024. Snickers 1025. The Hampton 1026. Pink Panther 1027. Dog House 1030. La Jolla #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 1032. Pink Dotted... 1051. Gold Mine 1053. Shabby Chic 1055. Wild Rose 1056. Black Shabby 1058. Birthday Cake 1059. Rouge  #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ 1061. Purple Wild... 1063. Baby Powder   1068. Daisy May   1068. Daisy May   1070. Pink Champ...   1072. Silver Bells   1083. Poppies #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________   Matching Slippers are available in: Black - size medium Hot Pink - size medium Pale Pink - size medium White - size small     Matching Slippers are available in: Black - size medium Hot Pink - size medium Pale Pink - size medium White - size small     #: ______________ #: ______________       #: ______________     Pink Sachet Purple Sache   Yellow Sache   White Sache   Blue Sache   Red Sache   #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL215: Antique Lac GL171: April in Paris GL208: Aqua Sky GL1006: Peachy... GL1008: Hot Stuff GL159: Big Polka GL190: Birthday ... #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL168: Blue Poodles GL142: Brigadoon GL104: Bubble Gum GL128: HBubbles GL211: Butterflies GL126: Cabbage... GL140: Carmen #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL153: Cleopatra ??? GL134: Damask GL221: Dangerous GL220: Devious GL124: Dew Drops GL165: Disco #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL160: English... GL194: Fan Dance GL143: Flamingo GL200: French Maid GL205: Fun At The. GL199: Garden GL184: Girls Best... #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL115:Groovy GL148: Hot Lips GL204: Hotel Savoy GL174: Jazz GL195: Jewel of the GL110: Key Largo GL201: Lady GaGa #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL146: Leopard Fab GL121: Leopard Fur GL172: Love in the... GL222: LuLu GL125: Mad for Plaid GL181: Midnight... GL166: Monkey Bus #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL120:Moulin Rouge GL116: My Fair Lady GL170: Monet's GL109: My Funny GL224: New Years... GL136: Night At.... GL141: Night Music #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL161: Ocean... GL133: Paradise GL130: Passion GL201: Pink clouds GL131: Pink Dotted... GL107: Pink Poppies GL117: Pink Swirl #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL122: Plum... GL137: Pop Art GL151: Psychedelic GL118: Purple Haze GL132: Roosters GL188: Rose Gard GL214: Royal... #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL163: Singing In... GL123:South Beach GL156: Smashing GL114: Spring Bloo GL198: Starshine GL152: Sterling... GL167: Strawberrie #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL173: Sunday in... GL202: Sunflowers GL127: Sunshine GL229: Sweet 16 GL106: Tango GL162: Treasure GL111: Tulips #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ GL169: Tuscan Sun GL209: Walk in the... GL154: White Wed... GL103: Wonder... #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________ #: ______________