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ORDER FORM
Please print or type this form, and fax your order to: 801-328-4801
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1. Assorted Chocolates
2. Nut Filled Creme Fondants
3. Creme Filled Fondants
4. Rum Victoria Pecan
5. Truffles (asst. flavors)
6. Caramels (plain and nuts)
7. Slowpokes
8. Fruits and Nuts
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9. Double Dipped Mints
10. Marzipan
11. English Toffee
12. Nut Brittles
13. Glazed, Salted Nut Meats
14. Pecan Logs
15. Chocolate Covered Nuts
16. Molded, Eatable Roses
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Please ship for:
(circle one)
Christmas
Thanksgiving
Now
Other ________________ (be specific)
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Sender:
Name: ___________________________________________
Address: ________________________________________
Apt. #: ___________
City, State, Zip: ___________________________________
Phone #: ___________________
Email: ______________________________
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Ship To:
Name: ___________________________________________
Address: ________________________________________
Apt. #: ___________
City, State, Zip: ___________________________________
Greeting From:: ___________________________________
_______________________________________________
_______________________________________________
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Please indicate Chocolate Coatings
L-Light, D-Dark, A-Assorted
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Asst#: ____
Asst#: ____
Asst#: ____
Asst#: ____
Total lbs: ____
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# of Boxes: ____
# of Boxes: ____
# of Boxes: ____
# of Boxes: ____
Total #
of Boxes: ____
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@ $19.70 per 1# lb. = $______
@ $37.40 per 2# lb. = $______
@ $55.10 per 3# lb. = $______
@ $90.50 per 5# lb. = $______
Total Candy Cost: $______
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Shipping Charges:
1 lb: $8.80
Add $1.00 to each additional pound.
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Utah Residents add .0660% tax: $_______
Shipping Charges: $_______
Total Including Candy and Shipping: $_______
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Payment Method: (circle one) Visa/MC AMEX Discover
Account Number: _______________________________
Expiration Date: ________________________________
Signature: ____________________________________
Prices subject to change, without prior notice.
Check address carefully. We cannot be held responsible if you give an incorrect address or apartment number, or suite number is not included!
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