Your Name in Chocolate™

You can use this page to print and send your order in through the mail.

Item Number	Item Name and the name(s) you want on them	How Many	Price Each	Total For This Item

	Please include your return address below!	Total Items		Sub Total
Name			Shipping
Address
City, State, Zip			Grand Total
Phone #

Please make checks or Postal Money Orders out to: USA MOLDS
(Please, no Western Union type money orders or payments will be accepted)

PLEASE, DO NOT SEND CREDIT CARD INFORMATION WITH YOUR ORDER IN THE MAIL!

USA MOLDS, 7558 W. THUNDERBIRD RD. SUITE 1-165, PEORIA, AZ 85381