PLIMOTH LOLLIPOP COMPANY

ORDER FORM

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Your Name:

Street Address:

City: State: Zip:

Telephone #: -      E-Mail:

Credit Card:       Master Card       Visa      Discover

Card Number:    Expiration Date:

Please ship me the following items:

Quantity

Item Number

Description

Price Each

Total Price
  Shipping & Handling $        8.50
  Total Order

 

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Click here to go to----->            Fall Lollipops Page

Click here to go to----->            Halloween & Thanksgiving Page

Click here to go to----->            Christmas Page

Click here to go to----->            Valentine's Day, St. Patrick's & Easter Page

Click here to go to----->            Choc Molded Page

Click here to go to----->            Decorated Page

Plimoth Lollipop Company
Revised: February, 2007