Mail or Fax to: Coons Candies
Name:__________________________________________________
Street:__________________________________________________
City: ___________________________________________________
State, Zip:_______________________________________________
Day Phone: ___________________________________(in case we need to contact you about your order )
___Payment Enclosed Amount ______________________________
___Master Card ___Visa #______________________________________________Exp.___/___
PLEASE CIRCLE THE (POUND SIZE) and EITHER "Assorted" or "Toffee" THAT YOU WOULD LIKE US TO SEND TO EACH OF YOUR FRIENDS LISTED BELOW
(Pound Size) 1 2 3 5 Assorted - Toffee
NAME________________________________
ADDRESS______________________________
CITY___________________________________
STATE & ZIP___________________________
(Pound Size) 1 2 3 5 Assorted - Toffee
NAME________________________________
ADDRESS______________________________
CITY___________________________________
STATE & ZIP___________________________
(Pound Size) 1 2 3 5 Assorted - Toffee
NAME________________________________
ADDRESS______________________________
CITY___________________________________
STATE & ZIP___________________________
(Pound Size) 1 2 3 5 Assorted - Toffee
NAME________________________________
ADDRESS______________________________
CITY___________________________________
STATE & ZIP___________________________
SIGN OUR GIFT CARDS:____________________________________________________
| 1 lb. - $13.00 +$6.25 S&H = $19.25 |
|
| 2 lb. - $25.50 +$6.75 S&H = $32.25 | |
| 3 lb. - $37.50 +$7.25 S&H = $44.75 | |
| 5 lb. - $60.00 +$8.25 S&H = $68.25 |