KaiVal Gift Baskets
…A Smile for Any Occasion
Phone: 514-895-9223 / Fax: 450-510-3922
Email: info@kaivalgiftbaskets.com
DATE: _____________________
Multi Basket Order Form
Please print, fill out and fax this form back to us on our secure fax line at 450-510-3922.
 
You may leave payment info blank and we will contact you for the information.
Client Information: ***  Payment Info:  ***
 Full Name:                                q  VISA      q  MC  
 Company Name:             Name on Card:      
 Address:               Cardholders Address:    
 Suite #:     City:                
 Province:     Postal Code:              
 Phone #:               Card Number:      
 Fax #:               Expiry Date:      
 Email:                       
Please complete the following:
#1 Basket Name:           QTY:   Price:  
Recipient Name:                    
Company Name:                  
Address:           Apt/ Suite:      
City:       Province:   Postal Code:      
Phone #:           Delivery Date:      
Card Message:  
                       
#2 Basket Name:           QTY:   Price:  
Recipient Name:                    
Company Name:                  
Address:           Apt/ Suite:      
City:       Province:   Postal Code:      
Phone #:           Delivery Date:      
Card Message:  
                       
Once your order has been received we will email or fax you a copy of your invoice showing
your total charges including delivery fees.    Thank you for your order!
Page 2 of 2…Continued
KaiVal Gift Baskets
… A Smile for any Occasion
Phone:514-895-9223 / Fax: 450-510-3922
Email: info@kaivalgiftbaskets.com
Multi Basket Order Form
Please print, fill out and fax this form back to us on our secure fax line at 450-510-3922
 
 
#4 Basket Name:           QTY:   Price:  
Recipient Name:                    
Company Name:                  
Address:           Apt/ Suite:      
City:       Province:   Postal Code:      
Phone #:           Delivery Date:      
Card Message:  
                       
#5 Basket Name:           QTY:   Price:  
Recipient Name:                    
Company Name:                  
Address:           Apt/ Suite:      
City:       Province:   Postal Code:      
Phone #:           Delivery Date:      
Card Message:  
                       
#6 Basket Name:           QTY:   Price:  
Recipient Name:                    
Company Name:                  
Address:           Apt/ Suite:      
City:       Province:   Postal Code:      
Phone #:           Delivery Date:      
Card Message:  
                       
#7 Basket Name:           QTY:   Price:  
Recipient Name:                    
Company Name:                  
Address:           Apt/ Suite:      
City:       Province:   Postal Code:      
Phone #:           Delivery Date:      
Card Message:  
                       
Once your order has been received we will email or fax you a copy of your invoice showing
your total charges including delivery fees.    Thank you for your order!