CHOCOLATE COVERED STRAWBERRIES
Date Needed to Pick Up (ex: Saturday:, May 1, 2006):
Pick Up Time:
Name:
Phone Number:
Email:
Name on Credit Card:
Card Number:
Billing Address:
Zip Code:
Expiration Date:
Security Code:
Comments or Questions:
Regular Chocolate Covered Strawberries - $1 Each
Quantity Needed:
If you don't want any you MUST put "0"
Tuxedo Strawberries - $2 Each
Quanitity Needed:
If you don't want any you MUST put "0"