Order Form
William Poll Baked PotatoThins™
(
Minimum
3 units)
3 for $25
Includes UPS Ground shipping
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Fill Order Form by typing information, Review, Print & Fax it to:
212.288.2844
or email to
wPollny@verizon.net
Order Date
Ship Date
Name
Address
City
State
Zip
Phone
Baked Potato Thins
•
(Minimum 3 units)
3 for $25
Baked Potato Thins 4oz
Cost ea
3 for $25
Quantity Ordered
Garlic
$7.00
Herbs de Provence
$7.00
Italian
$7.00
Jalapeno
$7.00
Mediterranean
$7.00
Moroccan
$7.00
Onion
$7.00
Original
$7.00
Rosemary
$7.00
Sesame
$7.00
Shallot & Pepper
$7.00
Sicilian
$7.00
Tex-Mex
$7.00
Credit Card Information
Payment
Credit Card Only
Shipping
UPS
Ground Included
Shelf Life
3 month
s
Authorized by
Credit Card #
Card Holder
Expiration
Fill Order Form by typing information, Review, Print & Fax it to:
212.288.2844
or email to
wPollny@verizon.net
William Poll Inc.
1051 Lexington Ave., NY, NY 10021
Tel 212.288.0501
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