THE
DIPPY CHICK COMPANY PRINTABLE ORDER FORM
www.dippychick.com
Before
proceeding, please understand that you can order more quickly
using our online form and you may be missing out on sales or
gift sets that are not reflected in this basic form. Shipping charges
are also more precise on our online form if you are ordering more than
12 dip mixes. You do not need to give a credit card on our site.
Simply order online and choose the check or money
order option at checkout. Further instructions will be given
for sending your payment.
Please
print this order form, fill it out, and mail it to us with your check
or money order to Dippy Chick,
PO Box 1085 - Hendersonville, TN 37075. Please make checks and money
orders payable to Dippy Chick.
SOLD
TO |
SHIP
TO (if different) (Continental US Only) |
NAME |
|
NAME |
|
STREET |
|
STREET |
|
. |
|
. |
|
STATE,
ZIP |
|
STATE,
ZIP |
|
| DAY
PHONE: |
EVE.
PHONE: |
| EMAIL
ADDRESS (if you check it daily): |
If this is a gift, please fill out the following. We will enclose a card
and omit the receipt.
QUANTITY |
DIP
MIXES |
EACH |
TOTAL |
. |
YA
GOTTA JUMP, CHIVE & WAIL (toasted onion & chive) |
|
. |
. |
BATTLESTAR
GARLIC-TICA (buttermilk garlic) |
|
. |
. |
ATOMIC
WEDGIE VEGGIE (vegetable medley) |
|
. |
. |
GETTIN'
PIGGY WIDDIT (bacon onion) |
|
. |
| . |
WHITE
MOUNTAIN MOOSE DIP (smoky cheddar bacon) |
|
. |
. |
PARMESAN
PESTO MANIFESTO (creamy basil pesto) |
|
. |
. |
DOWN
-N- DIRTY CHIPOTLE (smoky jalapeno) |
|
. |
. |
MAY
THE HORSE BE WITH YOU (horseradish dill) |
|
. |
. |
PEPPER
PAJAMA PARTY (bell pepper & chipotle) |
|
. |
. |
IN
THE DILL OF THE NIGHT (garlic dill) |
|
. |
. |
TWISTED
TOMATO TORNADO (tomato, basil & spinach) |
|
. |
. |
ITALIAN
SCALLION SUPER HERO (philly hoagie) |
|
. |
. |
CRABBY
OL' BEACH (tomato horseradish) |
|
. |
. |
CREAMY
PARMESAN PUPPERCORN (parmesan & black pepper) |
|
. |
| . |
KAMIKAZE
WASABI (horseradish mustard) |
|
. |
. |
DON'T
SQUAT WITH YOUR SPURS ON (buttermilk ranch) |
|
. |
| . |
TAKE
ANOTHER LIL' PIZZA MY HEART (pizza) |
|
. |
| |
SUBTOTAL |
|
| |
SHIPPING
(see table below) |
|
| Thank
you for your order! |
TOTAL |
|
| S&H
- PRIORITY MAIL - CONTINENTAL USA ONLY |
1 TO
12 DIP MIXES = $5.20 S/H |
| 13
TO 24 DIP MIXES = $6.80 S/H |
25
TO 36 DIP MIXES = $8 S/H |
BACK
TO DIPPYCHICK.COM
|