Print out this form and send it with your payment to:
Sweetwater Swimwear by Esha
715 B South 18th Street
Philadelphia, PA 19146
Phone:215-735-2926 (9-5 EST)

Name ________________________________________________ Date _______________

Address __________________________________________________________________

  __________________________________________________________________

Shipping Address: ____________________________________________________________

City _____________________________________ State ___________ ZIP ___________

Phone (_____)_____________ email: __________________________________________

___ Send catalog with order. ___ Send notices of special sales by email.