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DOWNLOAD THE APPLICATION FORM FOR MAIL IN  

or FILL IN THE FORM BELOW

Company Name:

 

Contact Person Name:
 

Phone Number:

 

E-mail Address:

 

Address:

 

Please List Store Location
For Pick Up of Cards:

 

Amount Requested
(Minimum of $1000.00)

 

HQF Scrip Discount Minus (10%)

 

Check Number
 
 
Office Use Only
Serial Numbers
Place Your Order Here
  Select Card Value Enter # of Cards Enter Your Total
     
 
     
 
     
 
  $ Total  

 

Please make your check payable to Holiday Quality Foods:
Send your payment to the address listed below:

P.O. Box 439
Cottonwood, CA 96022

Your order will be mailed to the designated store within 3-5 business days upon receipt of your check. The store manager will contact you when your order has arrived.

 

 

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