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Faxing Your Credit Card Information

Print out this page and fax us the following information.

To:Chocoholic.com
Fax Number:1-888-246-2648
Phone Number: 1-888-246-2648
Date: 
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  1. Your Name

  2. Phone Number:

  3. Type of Credit Card   (circle one:)   Visa    MasterCard   AmericanExpress

  4. Card Holder's Name as it Appears on the Credit Card:

  5. Credit Card Number:

  6. Credit Card Expiration Date:

  7. Order Reference Number:

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