PARA TI ORDER FORM

Order Information:				Order Form:
Phone:  591-464-55689				ITEM #	CATEGORY/DESCRIPTION	PRICE		QTY.		TOTAL
Fax Form :  591-464-54260
Send Form Via Mail To: CHOCOLATES PARA TI Casilla #482 Calle Armando Solares esq. Manuel Meleán Sucre, Bolivia South America
								Subtotal
					See chart at the bottom of this page  To find your shipping zone and price.			Shipping
								Total
Terms and Conditions:  All sales are final. Be sure your shipping and billing information is accurate. Losses due to incorrect shipping address are not the resposibility of Para Ti. Please double check all your information to ensure the safety of your shipment.				Ship To:
				Name
				Company
				City		State
				Country		Zip
				Email
Shipping Information: All sales are final. Be sure your shipping and billing information is accurate. Losses due to incorrect shipping address are not the resposibility of Para Ti. Please double check all your information to ensure the safety of your shipment. All personal information is kept confidential and will not be released or sold.				Billing Address:
					Check here if Shipping/Billing address are the same
				Name
				Company
				City		State
				Country		Zip
				Email
				Billing Information:
				Credit Card #
				Cardholder Name
				Card Number
				Expiration Date
				Payments can be made by bank checks written to "SOLUR S.R.L." and sent to our mailing address or can be deposited directly into the following accounts: Banco Nacional de Bolivia Cuenta No. 40000-45395, Banco Bisa Cuenta No. 25185-001-1: