Cotton Creations, Inc.
2655 W. Airport Road
Morris, IL 60450
Gift Basket Order Form to Print (2 pages)
| Name (Ordered by): |
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| Address: |
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| City/State/Zip: |
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| Phone: |
Email: |
| Name (Ship to): |
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| Address: |
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| City/State/Zip: |
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| Phone (for shipping): |
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Order Information
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Basket Name & Number as it appears on Basket Page |
Price |
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Indicate for a boy ________ or girl ______________ Please
provide any additional instructions on the back, such as gift card
information. |
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Shipping (Add 16.95) |
+ 16.95 |
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Total Enclosed |
Pay by (must be included with order) Check ___MasterCard___Visa____AmEx
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Credit Card Information:
Name as it appears on card:_________________________________________
Address where bill is mailed (include zip code): _________________________
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Card number_____________________________________Exp date _________