Collins Chocolates
841 Swicegood Rd.
Linwood, NC 27299
Date______________
Billing Information
Shipping Information
Name_________________________________
Address_______________________________
City________________State_______
ZipCode____________
Phone Number___________________
Email__________________________
Name________________________________
Address______________________________
City________________State_______
ZipCode____________
Phone Number___________________
Email__________________________
Enclose Money Order or Personal Check.
Please Circle Card: VISA MASTERCARD AMERICAN EXPRESS DISCOVER
Credit Card Number________________________
Exp.Date___________________________
3 digit number on back of card to verify address________
Please make sure that your name & address of the credit card you
are using is listed the same as the billing address above.
If you are ordering multiple orders which are going to multiple addresses, please be sure to fill out a new
order form for each order you are sending. Shipping rates apply to each address. Let us know if you want
a card with a message sent along & please write your message in the box below.
Standard Shipping for UPS Ground Delivery
Order Size up
to $25.00 $6.95
$25.01 - $38.00 $7.95
$38.01 - $50.00 $9.95
$50.01 - $75.00 $12.95
$75.01 - $100.00 $14.95
$100.01 - $150.00 $16.95
$150.01 - $200.00 $19.95
$200.01 - $250.00 $24.95
Please note that in summer
months candy is shipped in a
reusable styrofoam cooler/w
an ice pak. There is an
additional charge for this. Also
some orders have to be sent
via 2day or 3day service due
to the chocolates melting.
All orders that are done through the
web site using a credit card are a
slightly higher price. Then are no
exceptions to this rule.
Phone: 336 - 853 - 5200
Email: collins1219@aim.com
Due to the high cost of running a web site & the host & ecommerce getting their share of the
sales, our web site candies have to be priced higher. By ordering candies with this order form
and sending a money order or a personal check, we offer you, our customers close to home, a
cheaper price on our candies. Please allow 10 days for personal checks to clear. UPS is our
shipper. If you are in our area & would like to pick your order up from us, arrangements can be
made & there will be no shipping & handling charge added to your order.
All candies are made fresh when we receive your order so orders normally run a week, but
sometimes we get them out sooner. Around the holidays its pretty busy so place your order as
soon as you can. There may be a cut off date around the holidays if we get very busy. It just
takes time to make hand-made candies, but we will do our best to accommodate your needs.
We have a lot of product line that is not posted on the web site yet so we will inform you of new
items being added by email. We do have holiday candies we sell & will soon be coming out with
a full line of Military candies designed for each branch of the Military.
This charge
goes into the
shipping
charge box on
your order
form.