Chic-A-Loes

Famous Hot Sauce Order Form

Print this form off and mail it with your payment:

Customer Name:__________________________________________

Date of Order:____________________________________________

Check the size that you want to order:

Size ordered:      16oz_____     32oz_____      1 GAL_______

Please indicate total Quanity Ordered Here:__________________

Address of Customer:_____________________________________

__________________

Total amount of Order in US Currency, Made Payable by Money Order or Company Check    $________________________________

Checks should be made payable to:

Chic-A-Loes

Please allow time for Postal Delivery, no orders outside the continental United States.