The Chiltepin Order Form

Print and Mail this to:
The Jalapeno Cafe
3219 Kiesthill Dr.
Dallas, TX 75233

Write check to: Carol A. Blakely


Name ______________________________________

Address ______________________________________


E-mail address _______________________________

Sold as whole chilies only in a 1 ounce bags

Quantity, # of bags*__________

*______X $5.50 = $___________

Texas residents add 8.25 % sales tax $__________

Add $1.50 for first bag for Shipping $__________

Add $.50 for each additional bag$___________


Total sale( including shipping) $_____________

Write check to: Carol A. Blakely

Your order will go out the day we receive your check.
Thank you for your order!

  E-Mail The Jalapeno Cafe
if you have any questions or concerns.

Return to Chilies Page

Return to the Jalapeno Cafe