Cookie_Of_The Month

January	February	March	April



May	June	July	August



September	October	November	December



	Totals		Price (includes shipping)
		Subtotal (please enter)
Sales Tax 7.25 % (only applicable in IL)
Grand Total

Special instructions or message to accompany package: You may include a different message for each month ordered. Please number messages in the order you wish them to be sent.

Receiver's Information:

Name:

Street Address 1:

Street Address 2:

City: State: Zip Code:

Sender's Information:

Name:

Street Address 1:

Street Address 2:

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Phone Number: E-mail:

Billing Information:

Please Select: Expiration Date: Month Year

Credit Card Number:

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