This order form can be printed and sent to us at the address below.


SelectWisely Order Form -- PLEASE PRINT CLEARLY


Name _____________________________________________________ Date _______/_______/________

Street Address________________________________________________________

City ________________________________ State_______________ Zip ______________

Phone Number (_________)_________-___________________

Email Address ___________________@_________________________

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Card Name_______________________________________

Food(s) ________________________________________

Language(s) _______________________________________

Quantity ____________ Price $__________.______ Total Amount $___________



Card Name_______________________________________

Food(s) ________________________________________

Language(s) _______________________________________

Quantity ____________ Price $__________.______ Total Amount $___________



Card Name_______________________________________

Food(s) ________________________________________

Language(s) ____________________________________

Quantity ____________ Price $__________.______ Total Amount $___________

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Total Amount $_____________

Total Shipping/Handling $_____________ ($1.00 per card)

Total Tax $_____________ (if New Jersey resident add 7% sales tax)

Grand Total $_____________ (Total Amount + Shipping/Handling + Tax)

Make your checks payable to: SelectWisely
Mail your orders to:

   SelectWisely
   P.O. 289
   2 Main Street
   Sparta, NJ 07871