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Text File  |  1993-04-03  |  3KB  |  57 lines
  1.      CALL YOUR ORDER IN TOLL FREE! 1-800-582-5122         EPAC's 2nd Quarter
  2.                                                           Vacation Alaska SE
  3.                               TAKU SMOKERIES
  4.    Fax: 907-463-5209                                  Voice: 907-463-3474                                ORDER FORM
  5.                              230 S. FRANKLIN ST.
  6.                              JUNEAU, ALASKA 99801
  7.  
  8. FROM:
  9. Daytime Phone:____________________________
  10. Name:______________________________________________________
  11. Address:___________________________________________________
  12. Apt #:_____________________________________________________
  13. City :_____________________________________________________
  14. State:_____________________________________________________
  15. Zip  :_____________________________________________________
  16.  
  17. Desired Delivery Date:______________________
  18.  
  19. SHIP TO:                         
  20. Name :_____________________________________________________
  21. Address:___________________________________________________
  22. City :_____________________________________________________
  23. State/Zip:_________________________________________________
  24. Quanity___________Order#________Quanity________Order#______
  25. Desired Delivery Date:_______________________
  26.  
  27. SHIP TO:                           
  28. Name :_____________________________________________________
  29. Address:___________________________________________________
  30. City :_____________________________________________________
  31. State/Zip:_________________________________________________
  32. Quanity___________Order#________Quanity________Order#______
  33. Desired Delivery Date:______________________
  34.  
  35. SHIP TO:                           
  36. Name :_____________________________________________________
  37. Address:___________________________________________________
  38. City :_____________________________________________________
  39. State/Zip:_________________________________________________
  40. Quanity___________Order#________Quanity________Order#______
  41. Desired Delivery Date:_______________________
  42.  
  43.     (  )  My check or ( ) money order is enclosed.
  44.     (  )  VISA ( ) MC  ( )American Express
  45.     #__________________________________________
  46.     Exp. Date:_________________________________
  47.     Signature:_________________________________
  48.  
  49. Make check payable to:
  50.           Taku Smokeries
  51.   Gift Card message or Special Instructions
  52.  
  53.         Orders will be sent to the address above unless a gift
  54.         address is indicated. If a "desired delivery date" is not
  55.         listed the order will be sent on the next shpping date. (See
  56.         shipping information  on main menu of brochure.
  57.