Just Truffles Print & Mail Order Form

SOLD TO:		SHIP TO:
Name: _______________________________		Name: ______________________________
Address 1: ___________________________		Address 1: ___________________________
Address 2: ___________________________		Address 2: ___________________________
City: ________________________________		City: ________________________________
State: ____________	ZIP: _____________	State: ___________	ZIP: _____________
Daytime Phone: (____) ________________________		Daytime Phone: (____) ________________________
Message on Enclosure Card: ___________________________________________________
Credit Card: _________________________
Number: __________ - __________ - __________ -__________			Expiration: ___ / ___
Delivery Date Required: _____ / _____ / _____
We are unable to deliver to post office boxes Due to the perishability of our product, we recommend refrigeration Shipping costs may vary according to area and seasonability Shipping costs outside the contiguous 48 United States quoted separately No Monday deliveries $20.00 surcharge for Saturday deliveries

DESCRIPTION	LIQUOR	NON-LIQUORED	ASSORT	PRICE	QUANTITY
Gift Box (12)	xxxx	xxxxx	xxxxx	$44.50	xxxxx
Gift Box (8)	xxxxx	xxxxx	xxxxx	$28.50	xxxxx
Gift Box (4)	xxxxx	xxxxx	xxxxx	$14.50	xxxxx
Gift Box (2)	xxxxx	xxxxx	xxxxx	$8.00	xxxxx
Gift Box (1)	xxxxx	xxxxx	xxxxx	$4.00	xxxxx
Small Heart Box (4)	xxxxx	xxxxx	xxxxx	$17.95	xxxxx
Medium Heart Box (8)	xxxxx	xxxxx	xxxxx	$31.95	xxxxx
Large Heart Box (18)	xxxxx	xxxxx	xxxxx	$69.95	xxxxx
		Amount Total			xxxx
		Minnesota Residents Add 7.5% Sales Tax			xxxx
		UPS Ground $10.00 Each			xxxx
		2nd Day Air $21.00 Each			xxxx
		Overnight Air $42.00 Each			xxxx
		TOTAL			xxxx

FLAVOR	QUANTITY
Please indicated those flavors required or we will mix as specified on the order form above ** Denotes seasonal flavors
Peppermint Crunch	x
Cafe au Lait	x
Kirsch	x
Just Chocolate	x
Maple Nut	x
Caramel	x
Tenor's Temptation	x
Amaretto	x
Peanut Butter	x
Creme de Menthe	x
Bailey's	x
Pedcan Turtle	x
Kahlua	x
Chocolate Malted	x
Pumpkin Pleasure **	x
Apricot Brandy	x
Grand Marnier	x
Rum	x
Frangelico	x
Raspberry	x
Lemon Cheesecake	x
Key Lime	x
Cranberry **	x
Champagne	x
Vanilla	x
Plum Wine	x
Strawberry Cheesecake	x
Just Milk	x
"HOT" Chocolate	x
Chi Tea	x
Passion Fruit	x
Pears William	x
White Russian	x