Downtown Paiute Cigar Shoppe Order Form
DOWNTOWN - 1225 N Main Street, Las Vegas, NV 89101 - (702) 383-1514

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 JC Martinez at (702) 485-2341

Are you a new or existing customer?
What item(s) would you like to order? *
Please enter the product name(s). 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? *
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/
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
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