Please fill out and Fax this form to 1-877-647-DOGS (3647) Toll Free

Cardholder: 
Address:
City:
State:
 Zip Code:
Phone Number:
E-Mail Address:
Quantity:
Variety Pack:
$19.95 / pack
Holiday Pack:
$19.95 / pack
Variety Case:
$249.50 / case
Holiday Case:
$249.50 / case
Credit Card #:
Type:
Exp Date:
Cardholder:
Sub Total:
Shipping:

$5.95/pack
$2 each additional pack to same address.
$14.95 per case.
Sales Tax
(MD buyers only)
 5%
Total Cost:
Shipping info if different from Above:
Name:
Address:
City:
State:
Zip Code:

Comments or questions:
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