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Mail Order to: |
Please print this form to use for Mail or Fax orders. Thank you !!
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Mail Order to: |
| Ordered By: | Ship to (if different from left) |
| Name: | Name: |
| Address: | Address: |
| City: | City: |
| State/Zip: | State/Zip: |
| Daytime Phone: | E-mail: |
| Ship to arrive by: mm/dd/yy |
| [ ] Include Gift Card: |
[ ] Check [ ] Visa [ ] M/C [ ] Discover
| Name on Card: |
| Card #: Exp.: |
| Milk or Dark |
Quantity | Description | Unit Price |
Total |
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FL residents add 7% sales tax |
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Total Price |
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FedEx Shipping & Handling |
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Total Order |
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PERISHABLE PRODUCTS. ALL SALES ARE FINAL. |
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