Keepsake Candy Order Form

 

Occasion: __________________________________________________________________________

Item 1: _____________________ Design # ___________ Quantity: ________ Price: ________

Item 2: _____________________ Design # ___________ Quantity: ________ Price: ________

Item 3: _____________________ Design # ___________ Quantity: ________ Price: ________

                                                                                                              TOTAL: _______________

Front Wrapper Info: _____________________________________________________________________________________
_____________________________________________________________________________________

Back Wrapper Info: _____________________________________________________________________________________
_____________________________________________________________________________________

Date of Event: ________________________ Date Needed: ______________________

$25.00 Rush Fee (Needed less than two wks) _____Yes
$5.00 Photo Fee (one time fee not per wrapper) _____Yes 

Name: _________________________________________________________________

Address: _______________________________________________________________

Phone: _________________________ Email Address: __________________________

Shipping Address if Different: _______________________________________________ _________________________________________________________________________

Method of Payment: Visa____ MasterCard____ Check ____ Money Order ____

Credit Card # _________________________Expiration Date ____/____CVS # _______ (3 digit # on the back)

SHIPPING COSTS: __________________ (See Pricing Page to Add Shipping)
TOTAL: ______________
GRAND TOTAL: ____________________