ABasketBecause.com®... The Gift That Leaves a Lasting Impression
FAX ORDER FORM  PLEASE FAX TO: (914) 232-0545 
DATE_______TIME________Page___of___  PLEASE PRINT IN BLOCK LETTERS AS THIS WILL BE FAXED      

CUSTOMER NAME  (Fill in for page 1):

COMPANY NAME (IF ANY):

STREET ADDRESS:

CITY/STATE/ZIP:

PHONE:

 EMAIL:                                                                                   

CREDIT CARD NUMBER #  

EXPIRATION:

GIFT ITEM STYLE NUMBER:

GIFT ITEM SIZE: (IF ORDERING COOKIES - NUMBER OF COOKIES)

LARGE COOKIES OR COOKIE BYTES? (COOKIE GIFTS ONLY)

THEME CHOICE: IF ORDERING THEME GIFT ONLY:

RIBBON/TISSUE COLOR (NOT FOR THEME GIFTS)
(BURGUNDY, GREEN, LT. BLUE, LILAC, NAVY, ORANGE, RED, RED & GREEN, WHITE, PINK

COOKIE FLAVOR: (COOKIE GIFTS ONLY) (MIXED, OATMEAL BUTTERSCOTCH,
CHOC. PEANUT BUTTER, CHOC, COVERED PRETZEL OR CHOC. CHIP COOKIES

Would you like to add your logo to the gift tag?($1.50 each tag + set up fees and longer lead time)   YES   -   NO
Circle one.  If yes - please send logo to: logos@abasketbecause.com

COOKIES BECAUSE/A BASKET BECAUSE... (PUT YOUR PERSONAL MESSAGE HERE)


 

YOUR SIGNATURE: (FROM, LOVE, ETC. & NAME)

RECIPIENT NAME:

COMPANY NAME (IF ANY):

RECIPIENT STREET ADDRESS:

RECIPIENT CITY/STATE/ZIP: (CONTINENTAL US ONLY)

RECIPIENT PHONE (For shipping/follow up only):

SHIPPING TYPE (GROUND, 3 DAY, 2 DAY, 1 DAY):

A) ITEM PRICE

COUPON CODE:

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