CF Dominicana Quick Order Form

Use this 1 MINUTE quick form only if you are having trouble with our on line processing.

Be sure your info matches the card info.
We'll e-mail your order number later.


Name:
E-Mail:
Company:
Street Address:
City, State, Zip:	,
Phone:
Item that you would like and any comments/questions: (Item, size, quantity, flavor, etc.) *If you had trouble with our on line processing, briefly describe.
Payment Type	MasterCard Visa Amex
Credit Card number	exp:

Your credit card will be approved by us manually and we'll send you a confirmation e-mail and phone call.
Print this form for your records. (888)467.8400, fax (917)386.2686