Xocolatle®

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
$30.00 min.

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: