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Cookie Request Form

This information will be passed to a troop in your area and they will contact you.

For information, please contact Toni Carey, Product Sales Director at 385-3677, ext. 239.

* Required Fields
Contact Information
*Customer Name:  
*Customer Phone:  
*Customer EMail:  
 
Major Cross Steets:  
 
     
I Would Like to Order the Following:
       
boxes X $3.50 per box = $  
boxes X $3.50 per box = $  
boxes X $3.50 per box = $  
boxes X $3.50 per box = $  
boxes X $3.50 per box = $  
boxes X $3.50 per box = $  
boxes X $3.50 per box = $  
boxes X $3.50 per box = $  
       
Total payment due: boxes X $3.50 per box = $  
I would like to donate cookies to the men and women of the Armed Forces
       
boxes X $3.50 per box = $  
       
I heard about the Cookie Sale by: (check all that apply)
     
Girl Scouts Radio Web Site
Billboard Doorhangers TV
Friends & Family Other 
Comments:
         
 
 		  
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