Scrummy Gorgeous Order Form

Customer Name

First NameLast Name

E-mail

example@example.com

Phone Number

Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What date do you need your order by?

Pick-up is from Falls Church Farmers Market on Saturday mornings from 8am to 12pm. If you require an alternative date or time, please contact info@scrummygorgeous.com or text 571-386-9797

What date do you need your order by? Pick-up is from Falls Church Farmers Market, Saturday from 8am to 12pm or directly from Scrummy Gorgeous on non-market days.

Date

Is there any additional information you would like to share?

Please add any additional comments you might have regarding your order.

CUSTOM ORDER

Please provide as much detail as possible such as; occasion, product requested, theme, quantity, color, flavor/s, packaging, ribbons, date needed by.

Important Information

After submitting this form, you will be contacted within 24 hours to confirm your order.
Local Falls Church collection details will be shared in your confirmation email.
Payment is due at pick-up.
Turnaround time is 2-3 days. This can be longer during the holiday season.
If you have any questions, please email info@scrummygorgeous.com or call or text Maureen on 571-386-9797.

CHOCOLATE BOXES

Belgian Chocolate Assortment

Selection of 9 handcrafted Belgian chocolates including soft chewy caramel, smooth caramel, truffle, and Biscoff.

$25.00

	Quantity
Dark Chocolate
Milk & Dark Chocolate
Milk Chocolate

Item subtotal:

Belgian Chocolate Nut Assortment

Selection of 9 handcrafted Belgian chocolates including praline, pistachio, Dubai pistachio, hazelnut and caramel.

$25.00

	Quantity
Milk, Dark & White Chocolate
Dark Chocolate
Milk Chocolate

Item subtotal:

Belgian Chocolate Assortment

Selection of 9 handcrafted Belgian chocolates including caramel, mixed berries, truffle, Biscoff and solid chocolate.

$25.00

	Quantity
Dark Chocolate
Milk & Dark Chocolate
Milk Chocolate

Item subtotal:

Belgian Chocolate Truffles Cherry Blossoms

Belgian chocolate filled with a soft chocolate truffle center.

$13.00

	Quantity
Dark Chocolate
Dark & Milk Chocolate
Milk Chocolate

Item subtotal:

Belgian Chocolate Truffles Blossoms

Belgian chocolate filled with a soft chocolate truffle center.

$13.00

	Quantity
Dark Chocolate
Milk Chocolate
Dark & Milk Chocolate

Item subtotal:

Belgian Chocolate Truffles Butterflies

Belgian chocolate filled with a soft chocolate truffle center.

$13.00

	Quantity
Dark Chocolate
Milk Chocolate
Dark & Milk Chocolate

Item subtotal:

Belgian Chocolate Caramels

Belgian chocolate filled with a soft and a smooth caramel center. Each box contains 4 chocolates.

$13.00

Theme	Quantity	Price
Dark Chocolate		$13.00
Dark & Milk Chocolate		$13.00
Milk Chocolate		$13.00

Item subtotal:

Biscoff Belgian Chocolates

Belgian chocolate filled with a creamy, crunchy Biscoff filling.

$13.00

Theme	Quantity
Dark Chocolate
Milk Chocolate
Dark & Milk Chocolate

Item subtotal:

Dubai Pistachio

Belgian chocolate filled with pistachio cream, tahini and crunchy kataifi pastry.

$14.00

Theme	Quantity
Milk Chocolate
Dark Chocolate
Dark & Milk Chocolate

Item subtotal:

Mixed Berries

Belgian chocolate covered freeze dried raspberries, strawberries and blueberries.

$13.00

	Quantity
Dark Chocolate
Milk Chocolate
Dark & Milk Chocolate
White Chocolate

Item subtotal:

CHOCOLATE BARS

Flowers Chocolate Bar

Belgian chocolate bar decorated with handcrafted chocolate seasonal designs. Please click on the images to see the full range of themes and designs.

$12.00

Theme	Quantity
Dark Chocolate Bar
Milk Chocolate Bar

Item subtotal:

Belgian Chocolate Bar

Belgian chocolate bar decorated with handcrafted chocolate seasonal designs. Please click on the images to see the full range of themes and designs.

$15.00

Theme	Quantity
Roses Design Dark Chocolate Bar
Roses Design Milk Chocolate Bar
Cherry Blossoms Design Dark Chocolate
Cherry Blossoms Design Milk Chocolate

Item subtotal:

Love Hearts Belgian Chocolate Bar

Belgian chocolate bar decorated with handcrafted chocolate seasonal designs. Please click on the images to see the full range of themes and designs.

$12.00

Theme	Quantity	Price
Love Hearts Dark Chocolate Bar		$12.00
Love Hearts Milk Chocolate Bar		$12.00
Love languages Dark Chocolate		$10.00
Love languages Milk Chocolate		$10.00

Item subtotal:

Flower Arrangement Chocolate Bar

Belgian chocolate bar decorated with individually handcrafted chocolate flowers & set into a chocolate vase.

$20.00

	Quantity	Price
Dark Chocolate		$20.00
Milk Chocolate		$20.00

Item subtotal:

Cherry Blossom Design Chocolate Bar

Belgian chocolate bar decorated with individually handcrafted cherry blossom flowers.

$18.00

Theme	Quantity	Price
Dark Chocolate		$18.00
Milk Chocolate		$18.00

Item subtotal:

Chocolate Bar with Fruit Additions

Belgian chocolate bars with roasted nuts and freeze dried berries. Click on the image to see the full range.

$12.00

Type	Quantity
Berries Dark Chocolate
Berries Milk Chocolate
Berries White Chocolate
Strawberries Dark Chocolate
Strawberries Milk Chocolate
Strawberries White Chocolate
Orange Peel Dark Chocolate
Orange Peel Milk Chocolate

Item subtotal:

Dubai Pistachio Chocolate Bar

Belgian chocolate bar filled with rich pistachio cream, smooth tahini and crunchy kataifi pastry.

$18.00

	Quantity	Price
Milk Chocolate		$18.00
Dark Chocolate		$18.00

Item subtotal:

Chocolate Bars with Additions

Belgian chocolate bars with roasted nuts and freeze dried berries. Click on the image to see the full range.

$12.00

Type	Quantity	Price
Mixed Nuts Dark Chocolate		$12.00
Mixed Nuts Milk Chocolate		$12.00
Dubai Pistachio Dark Chocolate		$18.00
Dubai Pistachio Milk Chocolate		$18.00
Peanuts Dark Chocolate		$12.00
Peanuts Milk Chocolate		$12.00
Coconut Dark Chocolate		$12.00
Coconut Milk Chocolate		$12.00
Orange Peel 70% Dark Chocolate		$12.00
Orange Peel Dark Chocolate		$12.00
Orange Peel Milk Chocolate		$12.00
Lavender 70% Dark Chocolate		$12.00
Lavender Milk Chocolate		$12.00
Chili Flakes 70% Dark Chocolate		$12.00
Chili Flakes Dark Chocolate		$12.00
Chili Flakes Milk Chocolate		$12.00
Biscoff Dark Chocolate		$16.00
Biscoff Milk Chocolate		$16.00
Caramel Dark Chocolate		$16.00
Caramel Milk Chocolate		$16.00

Item subtotal:

CHOCOLATE COVERED OREOS

Chocolate Covered Oreos - Box of 2

Thin Dark Oreos covered in Belgian chocolate and seasonally decorated. Come in single, double or 6 pack boxes. Please click on the images to see the full range of themes and designs.

$12.00

Theme	Quantity
Cherry Blossoms Dark Chocolate
Cherry Blossoms Milk Chocolate
Cherry Blossoms Milk & White Chocolate
Hearts Dark Chocolate
Hearts Milk Chocolate

Item subtotal:

Chocolate Covered Oreos - Box of 6

Thin Dark Oreos covered in Belgian chocolate and seasonally decorated. Selection of dark, milk and white chocolate. Other designs and combinations can be requested.

$30.00

Theme	Quantity
Dark, Milk & White
Dark Chocolate
Milk Chocolate
Milk & White Chocolate

Item subtotal:

PRETZELS

Chocolate Caramel Pretzel Rod

Pretzel rods wrapped in soft caramel and dipped in rich Belgian chocolate.

$8.00

Chocolate	Quantity	Price
Dark Chocolate		$8.00
Milk Chocolate		$8.00

Item subtotal:

Total

Scrummy Gorgeous Order Form

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