21-22 Candy Bar Order Form

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Gertrude Hawk Chocolate is amazing and available in a 48ct. Box. Each bar is $1 for a total of $48/box.

Variety Boxes include: (12) Peanut Butter, (10) Caramel, (10) Crispy, (10) Solid Milk, (6) Solid Dark
Additional Flavors are also available in whole box flavors or a create your own blend.

A confirmation email will be sent once an order is received. We will not fill your order until you confirm that it was submitted by a parent/guardian.

Unless otherwise requested chocolate will be sent home with your child. Each child will sign/initial that they have taken the box of chocolate. We will not send more than one box of chocolate home at a time with a student riding the bus.

Payment is accepted in the form of: Cash / Check / Money Order / Credit Card (if paying for 2 boxes or more).

Email *

Name *

Oldest or Only Childs Name & Grade *

Factory Mix Box (12 PB, 10 Caramel, 10 Crispy, 10 Milk, 6 Dark) *

I would like the following number of custom blend boxes: *

I would like my custom blend box(es) to contain an even mix of the following flavors: *

Solid Milk Chocolate

Almond - SOLD OUT

Crispy

Caramel - SOLD OUT

Peanut Butter

Toffee/Almond

Sea Salt Caramel - SOLD OUT

Pretzel

Solid Dark Chocolate

Coconut Custard - SOLD OUT

Mint - SOLD OUT

Raspberry - SOLD OUT

Lava Cake - SOLD OUT

N/A - Just a Factory Mix for me!

Required

Comments for your order:

Distribution *

Please send my order home with my child who is private pick up

Please send my order home with my child who regularly attends Afterschool Care

Please send my order home with my child who rides the bus

DO NOT send my order home with my child. Pick up arrangements will be made during confirmation of the order.

I just want to help the sale succeed. Please deliver my box to the Lancaster Police or Fire Department.

I understand that chocolate bars CANNOT be returned for any reason & payment is due within 30 days of distribution. I will be paying by: *

Cash (receipts will be issued)

Check

Money Order

Credit Card (2 box minimum)

A copy of your responses will be emailed to the address you provided.

Submit

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