ZIGARELLI CHOCOLATES ORDER FORM


You may print this order form and submit it using either of the 
following ways:

Mail:  Zigarelli Chocolates
       15 Lorie Drive
       East Hanover, NJ 07936

OR 

Fax:   (973) 428-1420

For questions, please call (973)428-0000.


PERSONAL AND BILLING INFORMATION

This is the address to which your receipt will be sent, and also the
address to which products will be shipped unless otherwise specified
below.
                 
Name           _______________________________________________________

Address 1      _______________________________________________________

Address 2      _______________________________________________________

City           _________________________ State ____ Zip ______________

Phone          _______________________________________________________

E-Mail Address _______________________________________________________


SHIPPING INFORMATION

Only complete this area if you would like the products to be shipped to
an address other than the one listed above (i.e. a gift).

Name          _______________________________________________________

Address 1     _______________________________________________________

Address 2     _______________________________________________________

City          _________________________ State __ Zip ________________



ITEMS ORDERED


Item Code             Title            Qty    Unit Price   Line Price   

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________

________    _________________________  ____   ___________  ___________


                                         Product Total  ______________


Shipping and handling, and sales tax, if applicable, will be added to your 
order when processed. 


PAYMENT INFORMATION (Select one): 


_____  Check or Money Order (payment enclosed)


_____  Credit Card - Specify information below




CREDIT CARD INFORMATION: 

Select your credit card type:

____ Visa

____ Master Card

____ Discover


Name as it appears on card ______________________________________

Credit Card Number         ______________________________________

Card Billing Zip Code      ______________________________________

Expiration Date (mm/yy)    ______________________________________

Signature _______________________________________________________

                

COMMENTS:

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________


RETURN POLICY

No refunds or exchanges, all sales are final. Customr pays all 
shipping costs. We package our products very well. If merchandise 
arrives damaged, call us within 24 hours of receipt for an exchange. 


SHIPPING RATES

Shipping Rates can be viewed at the following website address
http://www.zigarellichocolates.com/shipping.html


Zigarelli Chocolates 
http://www.zigarellichocolates.com 


                 Thank You For Your Order!