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Order Request
Please answer all of the questions below. If you did not sell an item please enter 0 in its place. We will respond to you with a copy of your invoice and scheduled delivery or pick up times at this time as well.
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Email
*
Your email
Group or Organization Name
*
Your answer
First and Last Name
*
Your answer
Phone Number
*
Your answer
E-mail
Your answer
How are you receiving your fundraiser, pick-up or delivery? If you are receiving a delivery, what is your preferred time to receive your order?
*
Your answer
Preferred contact method
*
Phone
E-mail
Required
Item #1 Peanut Butter Meltie Chocolates
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Your answer
Item #2 Caramel Sea Salt Chocolates
*
Your answer
Item #3 Meltie Pretzel Chocolates
*
Your answer
Item #4 Six Count Chocolate covered Oreos
*
Your answer
Item #5 Chocolate Covered Mini Pretzels
*
Your answer
Item #6 Dark Chocolate Nonpareils
*
Your answer
Item #7 Half Pound Milk Chocolate Assortment
*
Your answer
Item #8 Peanut Butter Lovers Box
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Your answer
Item #9 Chocolate Cross Shape
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Your answer
Item #10 Chocolate Rabbit Shape
*
Your answer
Item #11 Chocolate Cat Shape
*
Your answer
Item #12 Chocolate Dog Shape
*
Your answer
Item #13 EGG- PEANUT BUTTER
*
Your answer
Item #14 EGG- COCONUT CREAM
*
Your answer
Item #15 EGG- MELTIE
*
Your answer
Item #16 FUDGE- Peanut Butter
*
Your answer
Item #17 FUDGE- Meltie
*
Your answer
Item #18 Cheddar Popcorn
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Your answer
Item #19 Kettle Popcorn
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Your answer
Item #20 Buffalo & Ranch Popcorn
*
Your answer
Item #21 Caramel Peanut Popcorn
*
Your answer
Item #22 Caramel Sea Salt Milk Chocolate Popcorn
*
Your answer
Item #23 Spider Popcorn
*
Your answer
Item #24 Meltie Popcorn
*
Your answer
Item #25 Cinnamon Bun Popcorn
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Your answer
Item #26 Cupcake Popcorn
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Your answer
Item #27 Jumbo Salted Cashews
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Your answer
Item #28 Gummi Bears
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Your answer
Item #29 Sour Gummi Worms
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Your answer
Item #30 Peach Rings
*
Your answer
Item #31 Dog Treats
*
Your answer
Questions and comments
Your answer
We are aware of the error on the form for items #13-17. Please use the numbering on the back of form where the order is written to enter totals.
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