Valentine Candy Gram Order Form



First Name of Valentine: _______________________     Last Name:__________________________

Mailing Address: _________________________________________________________________

City: ____________________________________ State: ___________ Zip: _____________

Choice of Wrapper for Candy Gram: #_____________

Message you would like printed on Candy Gram wrapper:

(Front)______________________________________________________________________________

(Back)______________________________________________________________________________

 

Your phone # and e-mail address in the event of a question. __________________________________ (REQUIRED)

 

Method of Payment:   Check ______          Money Order ______    Cash (In Person) ______

 

Billing Address: _________________________________________________________________   

 

City/Town:_________________________________     State: __________    Zip Code: _______

 

How did you hear about the Valentine Candy Gram?" ___________________________________________________

 

 

 

Please send this order form and $5.25 payment made payable to “Sweet Expressions”:

~ C/O Sweet Expressions ~ 40 Woody Crest Drive ~ Pittsburgh, Pa 15234 ~

Please contact me with any questions at 412-885-8055 ~ e-mail: kelleymeis@aol.com