Living Dynamics    

Personalized Candy Bars     

Order form

Name:______________________________________________________

Address:___________________________________________________

               ___________________________________________________

Type of Occasion: _____________________________________

Demographic Info: __________________________________

Background #: ______________________________________ If none, check here: ____________

Graphic design #: ______________________

Label design #: ________________________

Border #: __________________________

For labels with the Ingredient labels on back, provide 4 ingredients and the percentages:

1:___________________  %: _____      2: ____________________  %: ____

3:___________________  %: _____      4: ____________________  %: ____

Wedding Date: _____________________________

Bride: ____________________________  Groom: ________________________

Additional Comment: Other Specify: _______________________________________

Candy Bars are original Hershey’s Chocolate Bars. Please select type:

_____ Hershey’s Plain Milk Chocolate        ____ Hershey’s Milk Chocolate with Almonds

_____ Hershey’ Minis                                  ____ Hershey’s King Size (minimum 10 $3.50 ea)

Please select quantity (minimum order of 20):

_____ bars with labels   ___ with gold foil (add $6 per 20)

_____ Wine bottle labels  

____  Emailed preview ($2.00)*

____ life    ____ Breath Savers labels only (minimum 50) .30 each

____ Special request labels (gum, bubbles, Kit Kats, etc.) Please contact for price

*Would you like a preview of your label emailed to you?: Yes:__________  No: ______

*If yes, provide your email address: _________________________________________________

Would you like to include a photo on the label?: ___ yes    ___ no

If yes, please email or submit a wallet size or 3x4 photo with order form. (photos will be returned with order) and include an additional $5.00.

For additional designs and description of other Living Dynamics services, please visit our website at www.livingdynamics.tripod.com.

Payment method:

___ check or money order (make checks payable to Phyllis Johnson-Wiggins) allow 7 days for checks.

___ Paypal (contact for account information)

Payments are non-refundable, therefore, please make sure all required information is included with order, Emailed previews must be approved within 48 hours of submission, or the order will be processed. Please allow 1 week to process your order. We will do our best to insure all bars are intact and free of breakage; when shipped, however, we are not responsible for bars damaged during transport. Additional shipping charges will be added for orders placed between March and October for rapid shipping to avoid melting. Please consider ordering labels only for shipments to warm regions. Please email if you have any questions. I welcome special requests.