Thomas & Carman Convenience Stores

To order the "Giant Brownie or Giant Chocolate Chip Cookie" you may pay by check or money order $8.95:

1. Fill out the order form below

Your name	Your phone number
Your Address	Your City, State, Zip
Name of recipient Phone number of recipient:	*Address you want the gift basket delivered to
Your personal message limit 5 words	Indicate which you want to order: Giant Brownie Giant Cookie
Your E-mail:	E-mail of person you are sending gift to:
Student's Year in School Freshman Sophomore Junior Senior Grad Student	Date you want basket delivered

Please fill out this section for the gift card information.
The gift card will be sent to the delivery address you have indicated (*).

Please type any special message you wish to be included on the gift card:

2. Sign and date the form.

Signed__________________________________Dated__________________________________

3. Print form.

4. Enclose your personal check or money order made payable to Eastern Illinois University, and order form in an envelope, and mail it to:

Eastern Illinois University
600 Lincoln Ave.,
MLK Jr., University Union
Attn: Panther Dining
Charleston, IL 61920

Thank you for purchasing a Giant Cookie for your student.
If you have any questions, please feel free to contact us at 217/581-3700.

Brian Schneider Carman Assistant Director of Panther Dining

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