Mail/Fax Order Form for Credit Card Payments
For legibility purposes, please fill out form, then print.
Click here to print.

Billing Information

 *Required Fields
Name as Printed on Credit Card*:
Billing Address
for Credit Card:		 Street Address 1*
Street Address 2
City* State* Zip Code*
Credit Card Number*: (Visa, MasterCard, Discover, Am. Express)
Expiration Date*: Card Verification Number*:
E-mail address for payment confirmation*:
Phone Number for questions concerning order:

Shipping Information

 Fill in only if different from Billing Information
Delivery Name:
Shipping
Address:		 Street Address 1
Street Address 2
City State Zip Code
Cookbook Quantity & Shipping Options (Buy More & Save!)
# of Cookbooks
and Total Price		 Cookbooks shipped via
USPS Media Mail		 Cookbooks shipped via
USPS Priority Mail		 Ohio Residents add
7% sales tax
1 Book $16.99   + $3.00 + $5.00 + $1.19
2 Books $32.99   + $3.50 + $5.00 + $2.30
3 Books $47.99   + $4.00 + $9.00 + $3.36
4 Books $59.99   + $4.50 + $9.00 + $4.20
Mail completed form to:

OR

All Mixed Up, Ltd.
13176 Upper Lewisburg Salem Rd.
Brookville, OH 45309
Fax completed form to: 937-770-1331

Mail orders paid with a credit card will ship within 3 business days of receipt.
Orders shipped via USPS Media Mail take 2-9 days to arrive once sent.
 Orders shipped via USPS Priority Mail take 2-3 days to arrive once sent.
All orders shipped with Delivery Confirmation.
Charge on credit card will appear as Firehouse Pantry (our retail store).