Customer Information
Name_________________________________ City /St./Zip____________________________
Address_______________________________ Phone Number__________________________
Email Address__________________________
Cookie Name Size Qty.
Bella's Beefy Bites 16oz ______ 32oz ______ __________
Cooper's Favorite 16oz ______ 32oz ______ __________
Chic'n Cookie
Puggle PB&O Bars 16oz ______ 32oz ______ __________
(Peanut Butter & Oat)
Gus's Garlic &
Cheese Cookie 16 oz _______ 32oz _______ __________
Lulu's BBQ &
Honey Bears 16oz ________ 32oz ________ __________
Sample of ANY 3 cookie* Please specify flavors & size here________________________
Any 16 oz
$8 Any 32 oz $14
(Tax included in both prices)
Order Total ____________
Shipping cost (if applicable)____________
Total ____________
Currently we only accept checks. In the future we will accept PayPal. Please print off this order form and mail it with a check to the address below. Or you can email it to us at : MiggyLane@aol.com,please note your treats won't be sent until we receive payment
Mail payment to : Miggy Lane Shipping Costs
14147 Lincolnview 16oz Cookies $4.00
Petersburg, IL 62675 32 oz Cookies $4.50
FREE Shipping on orders of $25 or more
Email us about our "Refer a Friend Program" & Check out our "Miggy of the Month" Cookie Club Page!