"Love from Our Kitchen"  Cookbook Order Form

Print this form and return to:
Emory Creek Victorian Bed & Breakfast
Attn:  Beverly
143 Arizona Drive
Branson,  Mo.  65616
Allow 7 - 10 days for delivery.
Credit Card purchases may fax to - (417) 337-7045
Phone orders may call (800) 362-7404
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Name: ___________________________________________

Address:_________________________________________________

City _____________________     St _________  Zip ______

Tel.# (____)_____________   Email _______________________

Quantity: #___       Unit Price $_____    Total Price $_________
         

Method of Payment: ___________ Check Enclosed
                                ___________ Charge to Credit Card
      MasterCard ___________________________  Exp ______
      Visa _________________________________  Exp ______

Ship to address same as above  ___ Yes  ___ No
Please ship to address below -

Name: ________________________________________

Address - _____________________________________

City ______________________    St ____________    Zip ________
Would you like a note to be included with your gift? ___ Yes ___ No
Note to read-
________________________________________________________

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Additional Comments :