Sun Burst Coffee - Costa Rica

FOR THE BEST CUP BUY WHOLE BEANS & GRIND YOUR OWN!

MY CHOICE OF PAYMENT IS

Credit Card or Personal Check or Paypal

Type (VISA, MC,AMEX)

VISA
MasterCard
AMEX

Name on the card

Number of the card

Expiration date MM/YY

Card Validation Value
(3 or 4 numbers on card)

FOR BILLING PLEASE PROVIDE US WITH YOUR
NAME (First, Last)	,
E-MAIL
STREET ADDRESS
ADDITIONAL ADDRESS
CITY
STATE/PROVINCE
ZIP CODE
COUNTRY
TELEPHONE NUMBER

PLEASE SHIP TO (PREFERABLY TO YOUR BUSINESS)
SAME AS BILLING ADDRESS? Yes No

NAME (First, Last)	,
COMPANY NAME
HOTEL
STREET ADDRESS
ADDITIONAL ADDRESS
CITY
STATE/PROVINCE
ZIP CODE
COUNTRY
TELEPHONE NUMBER
YOUR GIFT CARD MESSAGE, INSTRUCTIONS OR COMMENTS

E-mail: sales@sunburstcoffee.com
Phone: (506) 228-1645 / 288-0249

Notice: Please make the check payable to
Cafe El Sol de Escazu & mail to:
Cafe el Sol Interlink 797 P.O. Box 025635 Miami Fl. 33102