Baskets of Plenty, Inc.        Fax Order Form

Customer/Purchaser Information:


Name:__________________________________________  Phone__________________

                                                                                                                  (Required)

Company Name:__________________________________  Phone__________________

Address: ________________________________________ Suite/Apt. # _____________

City_____________________________ State_______ Zip __________

E-mail ____________________________________________________


1st Gift Order

Recipients Name: __________________________________ Phone: _______________

                                                                                                                (Required)

Company: ________________________________________

Address: _________________________________________ Suite/Apt# ____________

                          UPS will not deliver to P.O. boxes

City: _________________________________ State: _________ Zip: ______________

Item: ____________________________ Price:__________ Delivery Date: _________

Message & Signature: _______________________________________________________________________

Comments: _______________________________________________________________________


2nd Gift Order

Recipients Name: __________________________________ Phone: _______________

                                                                                                                (Required)

Company: ________________________________________

Address: _________________________________________ Suite/Apt# ____________

                          UPS will not deliver to P.O. boxes

City: _________________________________ State: _________ Zip: ______________

Item: ____________________________ Price:__________ Delivery Date: _________

Message & Signature: _______________________________________________________________________

Comments: _______________________________________________________________________

You may make copies of this order form or send us your client list.

Fax to: 1-847-836-1909     Call: 1-847-836-5637 or 1-800-34-BASKET

www.basketsofplenty.com

____Visa    ____M.C.   ____Amex   ____Discover   ______Check or Money Order

                                                                                              Payable to Baskets of Plenty, Inc.

Credit Card #________________________________________ Exp. Date __________

Signature ___________________________________________ Date _______________

Signature Required. Payment is due at time of delivery. Orders over $500.00 require 50% deposit.