P.O. Box 640 - Camden, Alabama 36726 - Toll Free 1-800-967-3226 - Fax 334-682-9580 - www.joecwilliams.com
Ordered By: (please print clearly)

Name:_______________________________________________________________________

Business:_____________________________________________________________________

Address:_____________________________________________________________________

City/State/Zip:_________________________________________________________________

Daytime Phone:__________________ Email (no spam)________________________________

Have you ordered from us before? Yes___________ No_______________

Delivery Date:
____________At Once
____________Thanksgiving
____________Christmas
____________Other



Items To Be Shipped To Yourself
Item #
Quantity
Description
Price Each
Total Price
         
         
         
         
         

Items To Be Sent As Gifts

Ship To:________________________________________________________________

Business:________________________________________________________________

Address:________________________________________________________________

City/State/Zip:____________________________________________________________

Greeting To Read:_________________________________________________________

Gift Item No.______________________________________________________________

Price:____________

Delivery Date
____________At Once
____________Thanksgiving
____________Christmas
____________Other



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Ship To:________________________________________________________________

Business:________________________________________________________________

Address:________________________________________________________________

City/State/Zip:____________________________________________________________

Greeting To Read:_________________________________________________________

Gift Item No.______________________________________________________________

Price:____________

Delivery Date
____________At Once
____________Thanksgiving
____________Christmas
____________Other



------------------------------------------------------------------------------------------------------------------------------------------
Ship To:________________________________________________________________

Business:________________________________________________________________

Address:________________________________________________________________

City/State/Zip:____________________________________________________________

Greeting To Read:_________________________________________________________

Gift Item No.______________________________________________________________

Price:____________

Delivery Date
____________At Once
____________Thanksgiving
____________Christmas
____________Other



------------------------------------------------------------------------------------------------------------------------------------------
Ship To:________________________________________________________________

Business:________________________________________________________________

Address:________________________________________________________________

City/State/Zip:____________________________________________________________

Greeting To Read:_________________________________________________________

Gift Item No.______________________________________________________________

Price:____________

Delivery Date
____________At Once
____________Thanksgiving
____________Christmas
____________Other



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