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 product name(s). Please include cigarette size as well. Be as specific as possible:
Your answer
How many would you like to order? *
Please enter the quantity of the product you would like to order. 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
Never submit passwords through Google Forms.
This form was created inside of Las Vegas Paiute Tribe. Report Abuse - Terms of Service - Additional Terms