Dessert Order Form

Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Preferred Contact Method:*

EmailPhone
How did you hear about Cupcake On The Rocks?*
Choose your date of delivery (Please allow up to 48 hours)*

MonthDayYear
Please choose your product(s)*

Mini CupcakesBrowniesLetter/Number BrowniesDessert ParfaitsLetter/Number CakeMini CakesCookiesCake Pops

Dessert Selection/Menu*

12 Mini Cupcakes (1 Dz)$16.00

Choose up to 3 flavors/dozen (2 Dz Minimum)

Dozen	#1	#2	#3	Price
1st Dz				$16.00
2nd Dz				$0.00
3rd Dz				$48.00
4th Dz				$64.00
5th Dz				$80.00

12 Mini Alcohol Cupcakes (1 Dz)$48.00

Choose up to 3 flavors/dozen (2 Dz Minimum)

Dozen	#1	#2	#3	#4	#5	Price
1st Dz						$48.00
2nd Dz						$0.00
3rd Dz						$72.00
4th Dz						$96.00
5th Dz						$120.00

4" Mini Cakes (4-Pk) $30.00

Choose up to 2 flavors/ Pk

1st Flavor2nd Flavor1st Flavor 2

Mini Alcohol Cakes (4-Pk) $42.00

Choose up to 2 flavors/ Pk

#1 #2

Brownies (6-Pk) $25.00

Choose up to 2 flavors/ Pk

#1 #2

Tipsy Brownies (6-Pk) $30.00

Choose up to 2 flavors/ Pk

#1 #2

2 oz Shooters (12-Pk)$42.00

Choose up to 3 flavors/ Pk

#1 #2#3

5 oz Shooters (12-Pk) $54.00

Choose up to 3 flavors/ Pk

#1 #2#3

Delivery $ Free

Free pick-up available Tuesday-Saturday: RaceTrac Camp Creek, Barnes & Noble Smyrna, Barnes & Noble Morrow. Any deliveries up to 10 mi or up to 20 mi outside of any Free pickup location will result in a delivery charge. For mileage over 21 miles please contact us.

Test Desserts$16.00

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Important Reminders

After submitting this form, we'll check your order and we'll contact you within 24-36 hours for confirmation. Should you need confirmation sooner, please send us an email at orders@cupcakeontherocks.com
Method of Payment*
50% Deposit required on all orders submitted and confirmed.
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