Nordic Delicacies Order Form
Ship To:
Name_______________________________________________________________________________
Address (no PO Boxes, please)__________________________________________________________
City_______________________________________ State________ Zip_________________________
Telephone Number (day)___________________ Telephone Number (evening)___________________
Fax Number___________________ E-mail Address_________________________________________

Item Description Quantity Unit Price Total
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Total merchandise 
    
Shipping & Handling 
    
UPS Next Day Air 
    
Sub total 
    
Sales tax 
    
Total 
    

Method of Payment:
Please charge to my (check one):     American Express     VISA     MasterCard
Card # ______________________________________    Expiration Date:   Month________ Year______
Signature______________________________________________
Do you want us to fax over your order total prior to shipping?  Yes      No
Have your ordered from us before?  Yes     No
How did you hear of us (check all that apply)?    Family member    Friend   
 Have frequented the store     Internet search engine    Internet Link     Other