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Xocolatle®
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FAX ORDER FORM
Please print this form, fill out, and fax to 775.546.6065
or mail with payment to:
Cocoa Bibelot, 639 Stafford Way, Carson City, NV 89701
| ITEM | DESCRIPTION (write in single flavor or circle choice) |
PRICE | UNITS |
TOTAL PRICE |
| Truffles-4 pc. ballotin |
flavor: |
$6.50 | $ | |
| Truffles-12 pc. ballotin | flavor: | $15.00 |
$ |
|
| Truffles-22-26 pc. ballotin | flavor: | $28.00 | $ | |
| Chocolates-1/2# ballotin | flavor: | $16.50 | $ | |
| Chocolates-1# ballotin | flavor: | $38.00 | $ | |
| Chocolate Tea Set | Dark, Milk, or White | $35.00 | $ | |
| Tea Cup and Saucer | Dark, Milk, or White | $18.00 | $ | |
| Mini Tea Cup, Saucer, and Spoon | Dark, Milk, or White | $8.00 | $ | |
| Peachtree Cookies-1 dozen | n/a | $18.00 | $ | |
| Button Tarts-1 dozen | Strawberry, Rasberry, or Marmalade | $8.00 | $ | |
| Scone Mix-makes 1 dozen | n/a | $3.50 | $ | |
| Favors-2 pc.ballotin (50 sets min.) | gold/silver box; white/pink/ivory ribbon | $3.75 | $ | |
| Favors-4 pc. ballotin (50 sets min.) | gold/silver box; white/pink/ivory ribbon | $5.75 | $ | |
| Favors-2pc. duet sachet (25 sets min.) | white/pink/ivory ribbon | $2.75 | $ | |
| Summer Sucker-3 same | Daisy, Pansey, Rose, or Sunflower | $6.00 | $ | |
| Summer Sucker-6 same | Daisy, Pansey, Rose, or Sunflower | $10.50 | $ | |
| Summer Sucker-12 same | Daisy, Pansey, Rose, or Sunflower | $18.00 | $ | |
| Chocolate Easter Bunny | Dark, Milk, or White | $7.00 | $ | |
| Chocolate Bird Nest w/ Eggs | n/a | $18.00 | $ | |
| Chocolate Birdhouse | n/a | $32.00 | $ | |
| Strawhat w/ Bee | n/a | $15.00 | $ | |
| Chocolate Gardening Box | n/a | $15.00 | $ | |
| White Chocolate Box w/ Flower Basket | n/a | $4.50 | $ | |
| Round Chocolate Box with Rose Lid | n/a | $4.50 | $ | |
| Watering Can Sucker (3 min.) | Dark, Milk, or White | $2.00ea | $ | |
| Springtime Chocolate Assortment | n/a | $18.00 | $ |
We
accept Visa and MasterCard. For Mail orders, please fill out this form
with payment and mail to:
Cocoa Bibelot
639 Stafford Way
Carson City NV 89701
Make checks payable to:
Cocoa Bibelot
| SUBTOTAL | $ |
| SHIPPING/HANDLING | $ |
| TOTAL | $ |
| Shipping: | 2-Day Express $15.00 min. |
Overnight Air |
| Handling: | Up to 5 lbs. $7.00 |
5-10 lbs. $12.00 |
| Shipping Instructions |
| Name: |
| Physical Address: |
| City/State/Zip |
| Name on Card: |
| Visa/MC Card #: |
|
Exp Date: |
| Signature: |
