Rushmore Mountain Taffy Shop
Box 235, Keystone, SD 57751
Call us at 1-605-666-4430
or
Print out order form and
fax it to 605-666-4590
or mail it to us:

ORDER FROM:    ( Sender's name and address please )
Name:_________________________________________________________
Address: _______________________________________________________
City: _______________________ State: ___________ Zip:__________ 

Telephone Number: (________) _______-_______________ Ext: _______
SHIP TO:     (If different than order information)
Name: __________________________________________________________
Address: ________________________________________________________
City: _____________________________State: ___________ Zip: __________
Gift Card to read: _____________________________________________
 _________________________________________________________
Regular
Taffy		 Sugarless
Taffy		 Coconut
Brittle		 Peanut
Brittle		 Fudge Caramels  
1 lb.___ 1 lb.___ 1 lb.___ 1 lb.___ 1 lb.___ 1 lb.___  
2 lb.___ 2 lb.___
5 lb.___ 5 lb.___
   
Christmas Package 1 Christmas Package 2 Christmas Package 3 Christmas Package 4 Christmas Package 5 Christmas Package 6 Christmas Package 7
Pkg.___ Pkg.___ Pkg.___ Pkg.___ Pkg.___ Pkg.___ Pkg.___
Christmas Package 8 Christmas Package 9 Christmas Package 10 Christmas Package 11
Pkg.___ Pkg.___ Pkg.___ Pkg.___

Assorted Taffy______  or
Specific Taffy Flavors______________________
_______________________________________		 Order
Total $___________
 

Please charge my:
MasterCard  Visa  Discover

Number:___________________________________ Expiration:__________________
Name on card:_______________________________________________  
Signature:____________________________________________________

OR: (       ) Check or Money Order enclosed made payable to:

Rushmore Mountain Taffy Shop
Box 235, Keystone,  SD 57751
605-666-4430