S y l v i a 's B a k e r y

(630)971-0389 FAX # (630)971-1295 

PACZKI ORDER FORM P . M.
 THURSDAY FEB 11  FRIDAY FEB 12  SATURDAY FEB 13  SUNDAY FEB 14
 MONDAY FEB 15  TUESDAY, FEBRUARY 16
4 PC.BOX 6 PC. BOX  8 PC.BOX  10 PC.BOX 12 PC.BOX
__________CUSTARD w/chocolate icing ____________ CUSTARD w/powder sugar

__________RASPBERRY ______________CHOCOLATE CUSTARD

____________BLUEBERRY _ ___________BUTTER KREME

____________APRICOT _____________CHOCOLATE BUTTER KREME

____________STRAWBERRY PRESERVES _____________CHEESE

____________LEMON _____________BANANA KREME

____________PINEAPPLE ____________COCONUT KREME

____________APPLE ____________KEY LIME

____________CHERRY ____________POPPY SEED

____________FRESH STRAWBERRY ( $2.75 ea.) ____________PRUNE

___________ FRESH STRAWBERRY W / WHIP CRÈME ( 2.95 ea.) ______________________________________

__________________________________________________________________________________________________________________ 

______________TOTAL PIECES ORDERED @ $ 2.25 ea. + TAX = $______________________________________________ + TAX

PAYMENT FORM:  CASH  CREDIT CARD  WILL PAY @ P/U

CUSTOMER NAME :________________________________________________________________________________

TELEPHONE # _________ 630 - __________________________ - _____________________________________________________

# _______________ of__________________ CLERK__________________