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      

WHOLESALE CUSTOMER NAME  (Fill in for page 1):

WHOLESALE COMPANY NAME:

STREET ADDRESS/CITY/STATE/ZIP: ON FILE

PHONE: ON FILE

 EMAIL: ON FILE                                                     

CREDIT CARD INFORMATION: ON FILE

GIFT ITEM STYLE NUMBER:

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

THEME CHOICE: IF ORDERING THEME GIFT:

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

NOVELTY RIBBON: (IF ANY)  (+$1.50):THANK YOU, GET WELL, HAPPY BIRTHDAY, BABY BLOCKS,
JUST MARRIED, HAPPY ANNIVERSARY, BEST FRIENDS

LARGE COOKIES OR COOKIE BYTES? (COOKIE GIFTS ONLY)

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

GIFT TAG: (PUT YOUR PERSONAL MESSAGE HERE)


 

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):

C) ITEM PRICE (Retail-wholesale discount)