Truffles Order Form

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					Tr u f f l e s O r d e r F o r m 479.363.8129 Complete and mail the order form below with payment to: Eureka Sweets 14 Elk Street Eureka Springs, AR 72632 Item Price Assorted Flavors Box of 4 @ $6 Box of 6 @ $9 Box of 12 @ $15 Subtotal 10.875% tax Grand Total *Custom orders and Party Trays are available upon request. Please call 479-363-8129 for additional information. Shipping charges will be applied to your credit card upon completion and shipment of your order.


Customer Information Name _______________________________________ Address______________________________________ City, State, Zip ________________________________ ____________________________________________ ____________________________________________ Phone _______________________________________ Email ________________________________________

Shipping information: Name ____________________________________ Address __________________________________ City, State, Zip _____________________________

______________________________________ ______________________________________

Payment Method _____ Check Enclosed _____ Visa / Mastercard Card # ______________________________________ Expiration Date _______________________________ Signature ____________________________________

*Pickup Locations ______ Fayetteville, (Arsagas @ Crossover & Mission) ______ Eureka Springs (Little Bread Co.) *Deliveries are made every Friday. Confirmation of order will be emailed.

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