AFFAIRS® Chocolate Truffles: FAX Form for Shipping


*Place check mark in varieties selected
Double Chocolate
Kahlua
Washington Cherry
Mt.Tahoma Ice
Raspberry Brandy
Hazelnut
Toasted Almond
 Mocha
Mint Rainier
Cappucino
Old Dutch Milk
Irish Cream
White Satin
Butter Rum
 White Russian
Coconut
Amaretto
Grand Marnier
Apricot Rum
Praline

Ordered By:
My Name:

Daytime Phone:

Mail to This Address:

Name:

Firm:

Street Address:


City, State, Zip:

 Pricing:
1# Gift Assortment @ $25.00
1/2# Gift Box @ $12.75
l/4# Gift Box @ $6.55
Single Box @ $3.35

Please Send:
Quantity:

Total:

Shipping Charge, per destination:
Surface @ $5.00
2nd Day Air @ $12.00
Next Day Air @ $24.00
 Total All Truffles + Shipping:

Credit Card Type and Card #:


Expiration Date:

Delivery Date (on or before):


*Note: Affairs will send assorted boxes, or you may indicate specific choices by marking variety boxes at the top of this page.
boxes at the top of this page.