D. Auxilly Custom Couture Request Form
Couture Request
Email address *
Full Name *
Your answer
Phone Number *
Your answer
Occassion *
Your answer
Wear Date *
MM
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DD
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Type of Dress. Check all that apply. *
Required
Current US Dress Size
Budget Per Custom Piece *
Consultation *
If you would like a consultation, What date would you like to come in?
MM
/
DD
/
YYYY
How did you hear about D. Auxilly?
Submit
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