Txmoon-giftform
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Gift Order Form
DATE ______________
Sender’s Name ___________________________________________________________________ Address ________________________________________________________________________ City ___________________________________ State ________ Zip Code _________________ Phone ( ______ ) _________________________ Fax ( ______ ) ___________________________ Method of Payment:
Mastercard
Visa
AMEX
Credit Card # _________________________________________ Exp. Date: ________________ _ Name on Card ______________________________ Signature ____________________________ Ship To ________________________________ Address ________________________________ City ___________________________________ State ______ Zip Code _________________ 8oz _____ 8oz Holiday _____ 1lb _____ 13/4 lb _____
Ship To ________________________________ Address ________________________________ City ___________________________________ State ______ Zip Code _________________ 8oz _____ 8oz Holiday _____ 1lb _____ 13/4 lb _____
Message ________________________________ _________________________________________
Message ________________________________ _________________________________________
Ship To ________________________________ Address ________________________________ City ___________________________________ State ______ Zip Code _________________ 8oz _____ 8oz Holiday _____ 1lb _____ 13/4 lb _____
Ship To ________________________________ Address ________________________________ City ___________________________________ State ______ Zip Code _________________ 8oz _____ 8oz Holiday _____ 1lb _____ 13/4 lb _____
Message ________________________________ _________________________________________
Message ________________________________ _________________________________________
_________ _________ _________ _________
8 oz. Gift Tins 8 oz. Holiday Gift Tins 1 lb. Gift Tins 1 3/4 lb. Holiday Gift Tins
COST
$17.95 $17.95 $28.50 $45.00
S&H
$6.95 $6.95 $6.95 $6.95 TOTAL:
To place an order: Complete this form and fax to (903) 533-9895
TOTAL
_________ _________ _________ _________ _________
For longer gift lists, you may attach a mailing list with above information for each recipient. P.O. BOX 9686
•
Tyler, TX 75711
•
email: [email protected]
DATE ______________
Sender’s Name ___________________________________________________________________ Address ________________________________________________________________________ City ___________________________________ State ________ Zip Code _________________ Phone ( ______ ) _________________________ Fax ( ______ ) ___________________________ Method of Payment:
Mastercard
Visa
AMEX
Credit Card # _________________________________________ Exp. Date: ________________ _ Name on Card ______________________________ Signature ____________________________ Ship To ________________________________ Address ________________________________ City ___________________________________ State ______ Zip Code _________________ 8oz _____ 8oz Holiday _____ 1lb _____ 13/4 lb _____
Ship To ________________________________ Address ________________________________ City ___________________________________ State ______ Zip Code _________________ 8oz _____ 8oz Holiday _____ 1lb _____ 13/4 lb _____
Message ________________________________ _________________________________________
Message ________________________________ _________________________________________
Ship To ________________________________ Address ________________________________ City ___________________________________ State ______ Zip Code _________________ 8oz _____ 8oz Holiday _____ 1lb _____ 13/4 lb _____
Ship To ________________________________ Address ________________________________ City ___________________________________ State ______ Zip Code _________________ 8oz _____ 8oz Holiday _____ 1lb _____ 13/4 lb _____
Message ________________________________ _________________________________________
Message ________________________________ _________________________________________
_________ _________ _________ _________
8 oz. Gift Tins 8 oz. Holiday Gift Tins 1 lb. Gift Tins 1 3/4 lb. Holiday Gift Tins
COST
$17.95 $17.95 $28.50 $45.00
S&H
$6.95 $6.95 $6.95 $6.95 TOTAL:
To place an order: Complete this form and fax to (903) 533-9895
TOTAL
_________ _________ _________ _________ _________
For longer gift lists, you may attach a mailing list with above information for each recipient. P.O. BOX 9686
•
Tyler, TX 75711
•
email: [email protected]
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