Christmas Package Order Form
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: _____________________________________________
 _________________________________________________________

Quanity Discounts Available - Call for Pricing!
Gift
Pack 1		 Gift
Pack 2		 Gift
Pack 3		 Gift
Pack 4		 Gift
Pack 5		 Gift
Pack 6
Pkg.1______ Pkg.2______ Pkg.3______ Pkg.4______ Pkg.5______ Pkg.6______
Gift
Pack 7		 Gift
Pack 8		 Gift
Pack 9		 Gift
Pack 10		 Gift
Pack 11
Pkg.7______ Pkg.8______ Pkg.9______ Pkg.10______ Pkg.11______

 

Total for Packages _______________________  and
Total for Shipping _______________________
_______________________________________

 

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 Go to Home page