FAX ORDERFORM for Cookie Arrangements by Patti

Print This Page, Fill In the Information, Then FAX to 860-741-7248
or you can mail to PoBox 3355, Enfield, CT 06082, USA. If mailed, additional time must be allotted for the Postal Service.
If you need to talk to Patti, please call 860-741-5172

Your Information: Ship To Information.. Date Requested to Arrive:
Name: Name:
Address: Address (No PoBox, please):
Address: Address:
City: City:
State: ____________ Zip:________ Country:
State: _________________ Zip: __________ USA Main Land Only
Your Phone Number:  

Credit Card Information: MasterCard or Visa (circle one): Price is as depicted under each picture.

Number: Expiration Date ___/___

Type of Arrangement. Specify for Female or Male or Child or Family:

 

 

Greeting on Cookie:

Message on Card: