Fax Order Form

The Village Bake Shoppe
716-754-2300 877-754-2300
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FAX Order Form
FAX Number 1-716-754-0066
No order is filled until we call you back to confirm all information and costs.

Please print out an order for each separate gift receiver (don't forget something for yourself) or include a TYPED sheet with names, addresses and messages with this form.

Full Name:____________________________________________	Please send:
Address:______________________________________________	__________Basket __________$Amount
Company Name:_______________________________________	__________Box __________$Amount
City, State Zip:________________________________________	__________Bag __________$Amount
E-mail Address:________________________________________	_______Other (please describe)
Name on Credit Card:___________________________________	____________________
Card Type ___MC ___Visa ___Am Ex	____________________
Credit Card Number:____________________________________	____________________
Expiration Date:_______________________________________	____________________
Daytime Telephone:(____)_______________________________	______________$Amount

Recipient's Name:_________________________________	Type of occasion:__________
Address: ______________________________(no PO Box)	_________________________
City, State Zip:___________________________________	Message:__________________
Telephone: (___)__________________________________	_________________________
E-mail address:___________________________________	_________________________
Ideally this package should arrive by: ________________	_________________________

Important Shipping and Delivery Information We include custom-designed
gift cards with all orders. Each gift is carefully packaged and shipped separately by Federal Express
to ensure perfect arrival. Please check all of your addresses carefully. We can not guarantee orders
for which we are givenan incorrect address. It will be the sender’s responsibility to cover
expenses for reshipment or address correction costs if we were provided an incorrect address.

417 Center Street Lewiston, NY 14092 Telephone: Toll Free 877-754-2300 or 716-754-2300 FAX: 716-754-0066 E- mail orders to: We accept American Express, Mastercard, Visa and Discover ©MMI, The Village Bake Shoppe

417 Center Street Lewiston, NY 14092 Telephone: Toll Free 877-754-2300 or
716-754-2300 FAX: 716-754-0066
E- mail orders to:

We accept American Express, Mastercard, Visa and Discover
©MMI, The Village Bake Shoppe