Please print out this order form and FAX it to us at
(888) 870-9695 or (360)307-0585
| basket(s) ordered |
qty |
price each |
total |
| __________________________________ |
______ |
$___________ |
$__________ |
| __________________________________ |
______ |
$___________ |
$__________ |
| __________________________________ |
______ |
$___________ |
$__________ |
| __________________________________ |
______ |
$___________ |
$__________ |
| customer name:
________________________________________________ |
| billing address:
_______________________________________________ |
| city, state, zip:
_________________________________ |
_____ |
_________ |
| phone: (_________)
_____________________________ |
|
|
| email:
_____________________________________________ |
|
|
credit card: VISA (
) MasterCard ( )
Discover ( ) Amex ( )
card number:
______________________________________ exp: _____/_____
desired delivery date:
____________________________
shipping method: ( )
delivered (kitsap county only)
( ) shipped (U.S. only)
( )
standard ( ) two-day (
) overnight
When the gift is shipped or delivered, you will receive an
e-mail confirmation.
| recipient name:
________________________________________________ |
| shipping address:
_______________________________________ |
| city, state, zip
_________________________________ |
_____ |
_________ |
| phone: (_________)
_____________________________ |
|
|
| email:
_____________________________________________ |
|
|
| What would
you like the card to say? |
