Business Order Form Customized Chocolate Order* First Name* Last Name* Title* Your email* Subject Telephone Office Contact Person Mobile* Company Name* Department Address Line 1* Address Line 2 Postal Code Country* Select Appropriate: U.A.ESaudi ArabiaQatarOmanBahrainKuwaitOther State-Province* Select Appropriate: Abu DhabiDubaiSharjahAjmanUmm Al QuwainRas Al KhaimahFujairahRiyadhMakkahMadinahEasternAsirAl-BahaTabukQassimHailAl-JoufNorthern BordersJizanNajranDohaAl RayyanUmm Şalāl MuḩammadAl WakrahAl KhorAsh ShīḩānīyahDukhānMusayīdMadīnat ash ShamālAl WukayrAr RuwaysUmm BābAd DakhiliyahAl BatinahAl WustaAsh SharqiyahAd DhahirahMuscatMusandamDhofarAl BuraimiAl-JanūbīyahAl-ManāmahAl-MuḥarraqAl-WusṭāAsh-ShamālīyahAl-AḥmadīAl-ĀṣimahAl-FarwānīyahAl-JahrāḤawallīMubarāk al-KabīrOther City* Select Appropriate: Abu DhabiDubaiSharjahAjmanUmm Al QuwainRas Al KhaimahFujairahRiyadhJeddahMakkahHofufTaifMedinaAbhaAlBahaDammamTabukBuraidahHailSakakahArarJizanKhobarKhamisMushaitBuraydaNajranDohaAl RayyanUmm Şalāl MuḩammadAl WakrahAl KhorAsh ShīḩānīyahDukhānMusay‘īdMadīnat ash ShamālAl WukayrAr RuwaysUmm BābMuscatSeebSalalahBawsharSoharAs SuwayqAl BatinahIbriSahamRustaqBuraimiNizwáAd DakhiliyahSurManamaMuharraqHamadA-aliIsaSitrahBudayyiJidhafsAl-MalikiyahAl-ḤaddAr-RifāḤawallīAl-FarwānīyahAl-FinṭāsAl-JahrāJanūb al-KuwaytAl-ManqafAl-FirdawsMubarāk al-KabīrOther Industry* Select Appropriate: AirlineAutomotiveBankingBusiness ConsultantCommunicationConstructionEducationEnergy UtilityFinanceGovernmentInsuranceLegalManufacturingMedicalNon-ProfitPharmaceuticalReal EstateRetailServicesTechnologyTransportationTravelOthers Department Chocolate Gifts* Select Appropriate: Branded Chocolates / BarsTrufflesCustom Chocolate / Gift BoxTrayBasketGiveawaysFavorsOther Gift Occasion Check Appropriate: ConferencesPromotionsBrand LaunchSeminarsTrade Shows and ExposWorkshopsSpeaker SessionNetworking SessionsVIP ExperiencesSponsorshipsEmployee RecognitionSales and Marketing EventHolidaysCongratulationsAnniversaryBirthdayGet Well SoonNew Born BabyThank YouOther Customised Packaging Options Check Appropriate Boxes: Ribbon ColorInsertsHangtagOther Gift Value* Select Value Of Gift You want to Spend: 250500100025003500 Gift Numbers* Select Quantity Of Gift You want to Send: 15102530 Delivery Preference* Local DeliveryCourierShipping AddressSelf Pickup Message* I accept and agree to the Terms & Conditions