Winnsboro Bakery & Cafe

Printable Fax and Mail-in Order Form

PAY BY CREDIT CARD, MONEY ORDER, OR CHECK

Title (circle one):   Mr   |   Mrs   |   Ms   |   Miss

____________________________________________
Name

____________________________________________
Mailing Address

____________________________________________
City / State / Zip Code

____________________________________________
Telephone (including Area Code)

____________________________________________
E-mail Address

Payment (circle one): Check | Money Order | Visa | MasterCard

__________________________________________________
Card Number (Credit Card payments only)

__________________________________________________
Card Expiration (Credit Card payments only)

__________________________________________________
Daytime Telephone (including Area Code)

__________________________________________________
Fax Telephone (including Area Code)

__________________________________________________
Signature (Order MUST be Signed)

PRICES INCLUDE DELIVERY WITHIN CONTINENTAL USA

Item No Description Price Qty Item Total
W001 Original Sour Cream Pound Cake $23.95   $
W002 German Chocolate Pound Cake $23.95   $
01SD Apple Almond Gourmét Salad Dressing $13.95   $
02SD Balsamic Vinaigrette Gourmét Salad Dressing $13.95   $
03SD Lime Cilantro Gourmét Salad Dressing $13.95   $
Order Total $
PLEASE SHIP INDICATED ITEMS TO THE FOLLOWING INDIVIDUALS...

Title (circle one):   Mr   |   Mrs   |   Ms   |   Miss

_____________________________________________________
Name

_____________________________________________________
Mailing Address

_____________________________________________________
City / State / Zip Code

_____________________________________________________
Telephone (including Area Code)

_____________________________________________________
FROM (if not required, enter "None")

Item No Qty Delivery Date
[  ] At Once
[  ] Christmas
[  ] Other ______________
Item No Qty Delivery Date
[  ] At Once
[  ] Christmas
[  ] Other ______________
Item No Qty Delivery Date
[  ] At Once
[  ] Christmas
[  ] Other ______________

Title (circle one):   Mr   |   Mrs   |   Ms   |   Miss

_____________________________________________________
Name

_____________________________________________________
Mailing Address

_____________________________________________________
City / State / Zip Code

_____________________________________________________
Telephone (including Area Code)

_____________________________________________________
FROM (if not required, enter "None")

Item No Qty Delivery Date
[  ] At Once
[  ] Christmas
[  ] Other ______________
Item No Qty Delivery Date
[  ] At Once
[  ] Christmas
[  ] Other ______________
Item No Qty Delivery Date
[  ] At Once
[  ] Christmas
[  ] Other ______________
MAIL ORDERS TO:
Winnsboro Bakery & Cafe
210 N Main St
Winnsboro, TX 75494
PHONE ORDERS TO:
1-800-845-0512
FAX ORDERS TO:
903-342-7283
Important - To avoid duplication,
Do Not confirm fax orders by mail!