Order Form Phone 800-243-3739
Fax 815-379-9357
Mastercard
Visa   Card #           Exp. Date: ____/____
Name:___________________________________________________ 3 digit Sec. Code:_______
Address:_________________________________________________ e-mail:_______________________
City:_________________________ State:_________ Zip________________
Phone Number:  HM:_____________________   WK: ______________________
Description   Weight Price per # Quantity         Amount  Since cheese is sold
                at random weights your
                exact bill will be figured
                at the time of shipping.
                Prices do not include
                shipping and taxes.
Total    
  FedEX will only deliver to street addresses.  P.O. box numbers cannot be used.  
Gift Box:_______ Price:_________ Gift Box:_______ Price:_________
Send to:______________________________ Send to:______________________________
Street:_______________________________ Street:_______________________________
City:_____________ State:____ Zip________ City:_____________ State:____ Zip_______
Greeting Card to read: Greeting Card to read:
To: _____________________________ To: _____________________________
From: _____________________________ From: _____________________________
                     
Gift Box:_______ Price:_________ Gift Box:_______ Price:_________
Send to:______________________________ Send to:______________________________
Street:_______________________________ Street:________________________________
City:_____________ State:____ Zip________ City:_____________ State:____ Zip________
Greeting Card to read: Greeting Card to read:
To: _____________________________ To: _____________________________
From: _____________________________ From: _____________________________
                     
Gift Box:_______ Price:_________ Gift Box:_______ Price:_________
Send to:______________________________ Send to:_______________________________
Street:_______________________________ Street:________________________________
City:_____________ State:____ Zip________ City:_____________ State:____ Zip________
Greeting Card to read: Greeting Card to read:
To: _____________________________ To: _____________________________
From: _____________________________ From: _____________________________