DINNER THROUGH A STRAW - PRINTABLE ORDER FORM
Print out this page to fax or mail in your order.

QUANTITY
ITEM #
DESCRIPTION
UNIT PRICE
TOTAL PRICE
         
         
         
         
         
         
         
         
         
         
         
         
         
         
TN Sales Tax (9.75%) $
Shipping & Handling Charge   $
(U.S. Funds Only) Total Amount Due   $

Check Enclosed ______ Please Bill ______
Visa or Mastercard # _______________________________________________ Exp. Date ___________
Purchase Order # (where required) ______________________

SHIP TO:
Personal Contact Name _________________________________________________________
Business Name
_________________________________________________________
Address
_________________________________________________________
City
________________________________
State
_____
Zip
________________
Telephone
______________________________
Comments ________________________________________________________________________
  ________________________________________________________________________

MAIL YOUR COMPLETED ORDER FORM WITH A CHECK to:

Dinner Through a Straw
P.O. Box 332574
Murfreesboro, TN 37133

or

FAX YOUR PRINTED ORDER to: 615.494.5329

or

CALL US TOLL-FREE to place your order: 1.800.842.3841

Email: dinnerthroughastraw@yahoo.com

 

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