Santiago Chocolates: Order Form

James T. Dutton

200 Austin Avenue, Staunton, VA 24401
Email: info@santiagochocolates.com
Telephone: 540-885-1845

Order Form

(for chocolate bars and tablets)

Ordering and Payment Information. Use the order form below: enter the number of items you wish in the left column and the totals will be calculated automatically. The Virginia sales tax on food is included in the price. When you have finished entering all requested information, click the “Submit Order” button. You will receive a summary of the items you ordered and later an email from me confirming the order. That email will also contain information on payment, which may be by cash, check (made out to “Santiago Chocolates”) or online by credit card. If you need to change an order already submitted, it is best if you phone or email me.

Pickup of Chocolates. Chocolate bars and tablets should be ordered at least a day in advance. Use the “Additional Information” space below to state when you would like to pick them up.

Note: Some of the items are limited in number, and all are subject to availability. You will be notified if an item you ordered is out of stock.

Order Form for Bars & Tablets

No. of Items Ordered	Description	Price per Item	Subtotal
	Snacking Bar: caramel with sea salt	$6
	Snacking Bar: coffee ganache & vanilla buttercream	$6
	Snacking Bar: apple crisp	$6
	Tablet: almond praline with sour cherries	$6
	Tablet: blond chocolate with apricots	$6
	Tablet: hazelnut praline with caramelized hazelnuts & shortbread	$6
	Tablet: pecan praline with candied orange peel	$6
Total Cost of Items:

Total cost of order:

Enter the information in the boxes below. If I need to contact you about the order, I will use the email address you specify unless you prefer that I use the phone (if you do, please include your phone number below). All fields marked * are required.

Your Name:*
Your Email Address:*
Your Phone Number (if you prefer that for communicating):
Additional Information:

When your order is ready, you will receive an email requesting pickup information and explaining payment options.

Note: Clicking the Submit button more than once will result in the submission of multiple orders.