♥ ORDER FORM ♥

Name:
Email Address:
Contact Number:
Chocolate's Set Number:	Set 1 (Roses) Set 2 (Ketupat) Set 3 (Varies) Set 4 (Rectangular) Set 5 (Inclined Rectangular) Set 6 (Combination of Set 4 &5) Set 7 (Heart) Set 8 (Ball) Set 9 (Doraemon)
Other chocolate selections:	Horoscope (12 pieces per set) Hello Kitty Rectangular Chocolate Box Teddy Bear
Lollichoc:	BABY Flora & Fauna LOVE & XOXO
If combination, please state which design (e.g: BABY and LOVE & XOXO):
Designs for door gifts:	1 Heart & 2 Alphabets (initial name) 2 Hearts & 2 Alphabets (initial name) 2 Roses Bride & Bridegroom Rose & Heart Teddy Bear (ribbon excluded) Teddy Bear (ribbon included)
Chocolate's Type:	Dark chocolate Milk chocolate White chocolate Dark & white chocolates Milk & white chocolates Milk & dark chocolates
Types of filling:	Almond Assorted Hazelnut No filling (for lollichoc & chocolate box) Rice crispy Plain (no filling)
If assorted, please state (e.g: 25 pieces of almond, 25 pieces of hazelnut):
Event:	Anniversary Aqiqah (door gifts) Birthday (gift) Birthday (door gifts) Convocation Festive Engagement (hantaran) Engagement (door gifts) Wedding (hantaran) Wedding (door gifts)
For gift or hantaran, please select the types of packaging:	Box with cavities (ribbon excluded) Box with cavities (ribbon included) Transparent container (e.g: Hari Raya's cookies container) Your own box
Theme color (for white chocolate):	Blue Green Pink Purple No color
How many pieces of chocolates (minimum 25 pieces for Set 1-9):
If combination of chocolates, please state (e.g: 25 dark chocolates, 25 white chocolates):
Date of collection (e.g: January 23, 2011):
Other description (if any):

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