Please print out this order form and FAX it to us at (888) 870-9695
|
|
|
| basket(s) ordered | qty | price each | total |
| ____________________________________________ | ______ | $___________ | $__________ |
What would you like to change in this basket?
|
|
| 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? |