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Downtown Smoke Shop Order Request Form
DOWNTOWN - 1225 N Main Street, Las Vegas, NV 89101 - (702) 383-1522

PLEASE NOTE!: This form is only for requesting orders beforehand for pick up at our location.
This is NOT a form to order products online. If you would like faster service and direct
information on current stock and pricing please contact Nancy at (702) 383-1522.

Are you a new or existing customer?
What item(s) would you like to order?
Please enter the quantity and product name(s). Please include cigarette size as well. Be as specific as possible:
Your answer
When would you like to pick this order up?
Please enter the date below. Please also select the time you would like to pick this order up (our hours of operation are Monday to Saturday: 7am - 7pm and Sunday: 8am to 5:30pm).
MM
/
DD
Time
:
Contact info
Your name
Your answer
Phone number
Your answer
E-mail
Your answer
Preferred contact method
Required
Questions and comments
Your answer
Submit
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