Chili Man Organic Salsa Order Form

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Chili Man Organic Salsa Order Form
You may use our convenient order form to order your favorite Chili Man Organic Salsa!
Name:
Mailing Address:
E-Mail Address:
Yes, I wish to be added to the Chili Man Organic Salsa Mailing List.
Select Your Chili Man Organic Salsa Flavor Mild Medium Hot Quantity: Price is $3.00 per 16 oz. jar.
Credit Card (select one):
Name on Card:
Card Number:
Expiration Date:	/