Chocolate Heart Order Form

Hi there, thanks for your interest in my homemade chocolates. Each chocolate heart is made with love ♥. Order some in time for Valentine's Day or as a special treat for someone who deserves it. A few things to note about these yummies:

**INGREDIENTS**
Dark chocolate hearts are made with 60% dark chocolate, hazelnuts, and fresh blueberries. Milk chocolate hearts are made with milk chocolate, cinnamon, coconut, and pecans.

**FOOD ALLERGIES**
Chocolates contain milk products, hazelnuts or pecans, coconut. May have come in contact with peanuts.

**STORAGE & CONSUMPTION**
Since these treats contain fresh ingredients without preservatives, it is best to store them in the fridge. Devour within 5 days (if you can wait that long).
Contact Info
Name *
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Email Address *
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Chocolate Selection
Chocolate type 1 *
Quantity *
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Chocolate type 2
Quantity
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Chocolate type 3
Quantity
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Chocolate type 4
Quantity
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Packaging
Delivery Date

Payments are cash only upon delivery. Please allow 2 business days for delivery. Chocolates will be delivered to you at the office by Nell Pimentel during regular work hours on the delivery date you specify.
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Additional Notes
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