Order Form

Jackie's Bridal & Gifts
Order By Email or Print and Mail
Phone: (715) 228-3340

Jackie's Bridal & Gifts
201 Front Street
Coloma, WI 54930

Select and fill the items that apply, then fill in the quantity, description and totals of the items you want. Make a note of the total amount due for payment and Submit. We will contact you for your payment information.

Today's Date (mm/dd/yyyy):

Name:
E-mail:

DaytimePhone:

Evening Phone:
Billing Address:
Shipping Address:	If same as billing address, leave blank.

Tip: Be sure to enter the correct item number to expedite your order.

Quantity	Item #	Description	Amount	Total





			Total
Date you will need this order delivered (mm/dd/yyyy):

Type of Payment: Credit Card Personal Check Cashiers Check / Money Order

We will contact you for your payment information.
Shipping and tax will be added when we confirm your order.
Your order will not be finalized until we contact you.

You may print this page for a record of your order.

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Jackie's Bridal & Gifts Order By Email or Print and Mail Phone: (715) 228-3340

Jackie's Bridal & Gifts 201 Front Street Coloma, WI 54930

Jackie's Bridal & Gifts
Order By Email or Print and Mail
Phone: (715) 228-3340

Jackie's Bridal & Gifts
201 Front Street
Coloma, WI 54930