Personal DetailsPlease note that all information shared herein will remain strictly confidential. Any fields marked with * are required. First Name* Middle Name Last Name* Height*Please select an option<4'5"4'6"4'7"4'8"4'9"4'10"4'11"5'0"5'1"5'2"5'3"5'4"5'5"5'6"5'7"5'8"5'9"5'10"5'11"6'0"6'1"6'2"6'3"6'4"6'5"6'6"6'7"6'8"6'9"6'10">6'10"Weight (lbs)*Please select an option<160160-170170-180180-190190-200200-210210-220220-230230-250250-270270-300300-330330-360360-400>400Chest (in)Please select an option<40"40" - 44"45" - 49"50" - 59"60" - 69">69"Academic InformationJAG #* Please enter your JAG # beginning with J00Your College*Please identify the college you attend. Pat Capps Covey College of Allied Health Professions College of Nursing Have you completed the Nursing Convocation Participation Form for the Summer 2021 ceremony?* Yes No You must visit https://forms.gle/Vx6uxJy88xXEgG1p6 to complete the required convocation participation form before you can order.Degree*Please select oneBachelorMasterPost-Grad Certificate - NursingDoctorDegree*MasterDiscipline/Major Field of Study*Nursing (Apricot)Discipline/Major Field of Study*Health Sciences-PA Studies (Gold)Discipline/Major Field of Study*Nursing Practice - D.N.P. (Apricot)Complete Your OrderStudent Academic Apparel Keeper Package*Package includes cap, gown, tassel, and any applicable taxes Price: Student Academic Apparel Keeper Package*Package includes cap, gown, tassel, hood, and any applicable taxes Price: Student Academic Apparel Keeper Package*Package includes cap, gown, tassel, hood, and any applicable taxes Price: Doctoral Rental Packages*Doctoral Graduates have two rental options for their regalia needs. - Rental Package with Tam: Includes a Keeper Tam w/Gold Bullion Tassel, Rental Gown, and Rental Hood. - Rental Package with Mortarboard: Keeper Mortarboard, Keeper Tassel, Rental gown, and Rental hood. Both package prices include a pre-paid return shipping label and any applicable taxes. Please note: You will receive a $15 credit to the account you use below if you decide to drop your regalia off inside the USA Campus Bookstore by the August 13, 2021, deadline instead of using the return shipping label. Rental Package with Tam: $191.00 Rental Package with Mortarboard: $125.00 Regalia Delivery*You have the choice of picking up your regalia at the USA Student Center or having it shipped to your home - If you choose IN-STORE PICK UP: Your regalia order will be available for pick up starting July 19, 2021 in the Student Center, Room 205. - If you choose Ship-TO-HOME: Your regalia order will be shipped to you during the week of July 19, 2021. IN-STORE PICKUP: Free SHIP-TO-HOME: Email Address*Your receipt will be sent to the email address provided. If you do not receive a receipt via email, please check your spam/junk folder, then email email@example.com. Enter Email Confirm Email Billing Address*IMPORTANT - Please be sure to enter the billing information that is on file with your credit/debit card provider. Street Address * Address Line 2 City * State * ZIP Code * Shipping Address*PLEASE BE ADVISED: You must provide a physical street address where your regalia can be received during the weeks of July 19, 2021 and July 26, 2021 - PO Boxes are not acceptable. Same as Billing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Credit/Debit Card* DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number * Expiration Date * Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Security Code * Cardholder Name * RENTAL AGREEMENT: You are about to RENT academic regalia from Graduate Supply House, Inc. Students are allowed to retain their headwear (caps or tams) as souvenir items. All other items must be returned to either the USA Bookstore, located in the Student Center, or to Graduate Supply House, using the included pre-paid return shipping label, by August 13, 2021. Failure to return your rented items will prevent your diploma/transcripts from being mailed, and you may be subject to penalty fees up to full replacement cost of the regalia.I have read and understand the Rental Agreement above.* Agree I understand that I must visit www.gradsupply.com/student-orders by July 4, 2021, to cancel my order and receive a refund. I also understand that after the July 4, 2021, refund request deadline my regalia order becomes non-refundable.* Agree I have reviewed my responses and payment details above to verify accuracy.*- Please enter your (the graduate's) first and last names to verify Total Payment Amount $0.00 Once you click Submit, you will not be able to change or cancel your order.CommentsThis field is for validation purposes and should be left unchanged. How PayPal Works Contact Us © 2021 All Rights Reserved · Graduate Supply House, Inc.