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

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Name

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Mailing Address

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City / State / Zip Code

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Telephone (including Area Code)

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E-mail Address

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

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Card Number (Credit Card payments only)

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Card Expiration (Credit Card payments only)

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Daytime Telephone (including Area Code)

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Fax Telephone (including Area Code)

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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)

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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!